Midlands Mechanical Application 1. Application Question Title * 1. Name (Required.) Question Title * 2. Email (Required.) Question Title * 3. Phone (Required.) Question Title * 4. Address (Required.) Background and Experience Question Title * 5. Current (most recent) job title (Required.) Question Title * 6. Do you have Licenses/Certifications (Required.) Yes No Question Title * 7. List your Licenses/Certifications and what city, county, or state they cover. 1 2 3 Question Title * 8. Level of Education Attained (Required.) Grade School Some of High School High School or Equivalent Certification or Vocational Some College Associates Degree Bachelor’s Degree Masters Degree Doctorate Question Title * 9. Years of Experience (Required.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20+ Question Title * 10. Legally authorized to work in the U.S. (Required.) Yes No Requirements and/or Preferences Question Title * 11. Employment Type (Required.) Full- Time Employee Contractor Part- Time Employee Temporary Entry Level Intern/ Co-op Temp to Hire Seasonal Help Summer Help Question Title * 12. Available To Start Work (Required.) Date / Time Date Question Title * 13. Desired Hourly Rate Question Title * 14. Prior Employment Hourly Rate Question Title * 15. Enter other salary/benefit notes or preferences 20% of survey complete. Next
