PFI Online Application

		Power Flame Incorporated 2001 South 21st Street Parsons, KS 67357 620-421-0480
		Click here to download the application in PDF format

Power Flame Inc. considers all applicants for all positions without regard to race, color, national origin, religion, age, creed, gender, marital or veteran status, disability, handicap, or any other legally protected status.
Date:	ALL QUESTIONS IN RED ARE REQUIRED
First Name:
Middle Name:
Last Name:
Address:
Address (continued):
City:
State:
Zip-Code:	(first 5 numbers only)
Email Address:
Telephone Number:	(numbers only please)
Position Applied For:
Type of employment desired:
Date available to begin work:	(mm/dd/yy)
Desired Salary:	$ /
Were you referred by a Power Flame employee?
If yes, employee name
Have you ever been employed by Power Flame Inc? ........................................................		Yes No
If yes, dates employed to: position(s) held:
Are you able to meet the attendance requirements of the position for which you are applying?		Yes No
Will you work overtime if required?.....................................................................................		Yes No
Are you legally eligible for employment in the United States?................................................ (Proof of U.S. Citizenship or immigration status will be required upon employment)		Yes No
Are you at least 18 years of age?.........................................................................................		Yes No
Have you ever been convicted of a felony?..........................................................................		Yes No
If you answered "Yes" to the above, please explain: (Answering "Yes" does not automatically bar an applicant from employment. Factors such as date of the offense, severity and nature of the violation, rehabilitation, and position applied for are taken into consideration.)

Please provide the following information regarding your last (3) three employers, beginning with the most recent.

Dates Employed: Currently employed with this employer? From: (mm/yy) To: (mm/yy) Starting Job Title: Ending Job Title:	Employer Name: Address: Immediate Supervisor/Title: Phone Number: (numbers only please) May We Contact This Empolyer? Yes No	Starting Pay: $ / Ending Pay: $ / Reason for leaving: Characters remaining
Dates Employed: From: (mm/yy) To: (mm/yy) Starting Job Title: Ending Job Title:	Employer Name: Address: Immediate Supervisor/Title: Phone Number: (number only please) May We Contact This Employer? Yes No	Starting Pay: $ / Ending Pay: $ / Reason for leaving: Characters remaining
Dates Employed: From: (mm/yy) To: (mm/yy) Starting Job Title: Ending Job Title:	Employer Name: Address: Immediate Supervisor/Title: Phone Number: (number only please) May We Contact This Employer? Yes No	Starting Pay: $ / Ending Pay: $ / Reason for leaving: Characters remaining

Skills and Qualifications

Summarize any specialized training, licenses, skills and/or certificates you have received that may qualify you as being able to perform job-related functions in the position for which you are applying.

Characters remaining

Education

Name and Location	Years Completed	Course of Study / Degree or Diploma
High School:
College:
Trade School or Other: (if job related)

Please list any additional comments or information, including explanation of any gaps in employment, which you would like for us to consider.

Charaters remaining

Application Statement

I certify that the information I have provided in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be sufficient cause for denial of employment or immediate discharge. I expressly authorize, without reservation, the employer or its representatives to use any information in this application to verify my statements. I expressly authorize, without reservation, past employers, all references, and any other persons to answer all questions asked concerning my ability, character, general reputation, characteristics, mode of living and previous employment. I release all such persons from any liability or damages for having furnished such information. I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Power Flame Inc.and myself for either employment or for the providing of any benefits. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding Power Flame Inc. unless made in writing and signed by the President. If I am hired, I understand that I have the right to terminate my employment at any time, with or without notice and with or without cause, and that Power Flame Inc. reserves the same rights. I understand that a condition of employment with Power Flame Inc. is participating in a test for illicit drugs and/or alcohol. I further understand that failure to consent to this test, adulterated sample, or a positive test will be considered a withdrawal of any conditional offer of employment. I also consent to testing for illicit drugs and/or alcohol while employed by Power Flame Inc. I also understand that, if I am hired, I will be required to provide proof of identification and verification of my eligibility to work in the United States, and that Power Flame Inc. will require me to complete an I-9 Form for this purpose.

DO NOT SUBMIT APPLICATION UNTIL YOU HAVE READ THE ABOVE STATEMENT.
I certify that I have read, fully understand and agree to the conditions in the application statement above.