NAME DATE ______
APPLICATION FOR GENERAL MAINTENANCE AND REPAIR TECHNICIAN SENIOR
1. Have you read the job description for General Maintenance and Repair Technician Senior and do you understand the duties of such a position?
2. Do you have experience in the electrical field? If yes, please list where, when, and for how long. (If additional space is needed, use the back of this sheet.)
3. Have you participated in any formalized electrician training? If yes, please list where and when.
4. Do you have experience in the plumbing field? If yes, please list where, when, and for how long. (If additional space is needed, use the back of this sheet.)
5. Have you participated in any formalized plumbing training? If yes, please list where and when.
6. Have you participated in any formalized custodial or janitorial training? If yes, please list where and when.
7. Describe total experience you have had in the custodial field.
8. Are you willing to work the morning shift (6:00 a.m. to 2:30 p.m.)?_
(Or, if necessary, the evenings shift (1:30 p.m. - 10:00 p.m.)?
9. Are you willing to work a Tuesday through Saturday workweek?
10. Can you lift trash containers, equipment, and furniture? If no, please explain.
11. Can you work on your feet for long periods of time doing custodial tasks? If no, please explain.
12. Can you climb stepladders or use lifts to wash windows, replace light bulbs, and perform similar tasks?
13. Can you climb stairs? If not, please explain.
14. Do you know how to operate a vacuum cleaner?
15. Do you know how to operate a floor-scrubbing machine?
16. Do you know how to operate a rug shampooer?
17. Do you know how to operate a floor-polishing machine?
18. Do you have knowledge of the materials, methods, and practices used in cleaning operations?
PITTSBURG STATE UNIVERSITY IS AN EQUAL OPPORTUNITY, AFFIRMATIVE ACTION AND VETERAN’S PREFERENCE EMPLOYER. EMPLOYMENT WILL REQUIRE A CRIMINAL BACKGROUND CHECK.
PHYSICAL PLANT CUSTODIAL AND GENERAL SERVICES - EMPLOYMENT INFORMATION
PITTSBURG STATE UNIVERSITY
PRESENT DATE
NAME (print) (LAST) (FIRST) (MIDDLE)
PRESENT ADDRESS (STREET, ROUTE, BOX) (CITY)
TELEPHONE STATE ZIP
PLEASE LIST YOUR EDUCATION AND TRAINING:
NAME AND ADDRESS OF SCHOOLS: CIRCLE HIGHEST GRADE COMPLETED
GRADE SCHOOL 1 2 3 4 5 6 7 8
HIGH SCHOOL 9 10 11 12
DESCRIBE FULLY ANY BUSINESS, CORRESPONDENCE, TRADE SCHOOL, OR COLLEGE TRAINING. GIVE FULL DETAILS REGARDING COURSES TAKEN, HOURS CREDIT, AND MAJOR SUBJECT STUDIED.
DEGREE OR HOURS NAME AND LOCATION OF SCHOOLS TYPE OF SCHOOL/MAJOR COMPLETED
POSITION DESIRED AND QUALIFIED FOR
WILL YOU ACCEPT TEMPORARY EMPLOYMENT? ______REFERENCES (OTHER THAN RELATIVES):
NAME ADDRESS CITY PHONE
(OVER)
EMPLOYMENT HISTORY: (Last position first)
Are you presently employed? yes no part-time full-time
May we contact your current employer? yes no
Employer Position Held Address Employed from to (Street) (City) Salary (Per month) Supervisor’s Name
DUTIES
Employer Position Held Address Employed from to (Street) (City) Salary (Per month) Supervisor’s Name
DUTIES
Employer Position Held Address Employed from to (Street) (City) Salary (Per month) Supervisor’s Name
DUTIES
Employer Position Held Address Employed from to (Street) (City) Salary (Per month) Supervisor’s Name
DUTIES
Employer Position Held Address Employed from to (Street) (City) Salary (Per month) Supervisor’s Name
DUTIES
I authorize Pittsburg State University to utilize the information given in determining my eligibility for employment. Fraudulent statements made on this application may be cause for dismissal.
I understand that, as a condition of employment, PSU reserves the right to grant compensatory time off in lieu of overtime hours worked.
Signature
Information received by Pittsburg State University will be handled confidentially.
PITTSBURG STATE UNIVERSITY IS AN EQUAL OPPORTUNITY, AFFIRMATIVE ACTION AND VETERAN’S PREFERENCE EMPLOYER