Online Application "*" indicates required fields1Personal Information2Education3Employment HistoryHiddenLead SourceOtherHiddenLead Source-SpeccificEmployment ApplicationHiddenTypeApplicantPosition Applying For:*Name* First Last Phone*Email* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Shift Availability* 1st Shift 2nd Shift 3rd ShiftShift Preference* 1st Shift 2nd Shift 3rd ShiftHours* Full Time Part TimeAvailable Start Date* MM slash DD slash YYYY Expected Pay Rate*How did you hear about this position?*Select from options belowCurrent employeeFire-Dex websiteGovernment agencyHandshakeIndeedJob fairSchoolSocial MediaZipRecruiterOtherSelect the referring social media:Select from options belowFacebookInstagramLinkedInPinterestTwitterOtherList referring employee's full name below:List the specific other source below:Are you legally authorized to work in the U.S.?* Yes NoHave you ever been convicted of a criminal offense?*Answering “yes” to the following question does not constitute an automatic disqualification of employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. Yes NoIf yes, please indicate the number of incidents/charges, provide date(s) and details including the nature of the incident(s) and the resolution*Have you ever worked for Fire-Dex?* Yes NoWhat were the dates of your employment?*Have you completed the following level of education: High school or equivalent?* Yes NoEDUCATIONHighest Level of Education*Did not complete High SchoolHigh School Graduate or EquivalentSome College, No DegreeTrade/Technical/Vocational TrainingAssociate DegreeBachelor's DegreeMaster's DegreeHighest Grade CompletedName of High School*Higher EducationIf applicable, please provide the following information on any additional training, certificates, or degrees achieved.Name of SchoolDegree/CertificateArea of StudyYears Attended Add RemoveEmployment HistoryStarting with your most recent employer, provide the following information on your past 3 positions. If you do not have previous employers, use N/AMOST RECENT EMPLOYERPlease list your 3 past employers, indicate n/a if you don’t have that many.Previous Employer's Name*Immediate Supervisor’s Name & Title*Previous Employer's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Phone*May we contact this employer?* Yes No OtherStart Date* MM slash DD slash YYYY Currently EmployedIf you are still working in this position, choose today as the End Date and check the box below. Still working for this employer.End Date* MM slash DD slash YYYY Job Title*Reason for Leaving/Wanting to Leave*Summary of Job Responsibilities*Starting Wage*Ending Wage*SECOND EMPLOYERPrevious Employer's Name (2)*Immediate Supervisor’s Name & Title*Previous Employer's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Phone*May we contact this employer?* Yes No OtherStart Date* MM slash DD slash YYYY Currently EmployedIf you are still working in this position, choose today as the End Date and check the box below. Still working for this employer.End Date* MM slash DD slash YYYY Job Title*Reason for Leaving*Summary of Job Responsibilities*Starting Wage*Ending Wage*THIRD EMPLOYERPrevious Employer's Name (3)Immediate Supervisor’s Name & TitlePrevious Employer's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State PhoneMay we contact this employer? Yes No OtherStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Job TitleReason for LeavingSummary of Job ResponsibilitiesStarting WageEnding WageADDITIONAL INFORMATIONSummarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying and/or list any additional job-related information you would like us to know about you:PROFESSIONAL REFERENCESPlease Note: Professional References cannot be relatives.Professional References*Please provide the following information on 3 professional references. Click the "+" to add the next reference.NameTitleRelationship to YouPhone NumberYears Known Add RemoveDOCUMENT UPLOADAttach FilesIf you would like to upload your resume (strongly encouraged) you can do so here. Drop files here or Select filesMax. file size: 63 MB, Max. files: 3.PLEASE READ AND UNDERSTAND THE POINTS BELOW BEFORE CLICKING SUBMIT: I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to 1) eliminate me from further consideration for employment, or 2) may result in my immediate discharge from the employment of Fire-Dex, LLC whenever it is discovered. I affirm that I have read and understand the above information and that the information I have given Fire-Dex, LLC is accurate and complete.Δ
