Application form




8 hour shifts, Days

Previous Experience Required

Minimum 3 years hospital and/or facility maintenance experience, which should include hands-on experience in general maintenance and repair, electrical, plumbing and HVAC.

Specialized or Technical Education Required

High school diploma or equivalent.

Manual or Physical Skill Required

Requires considerable hand-eye coordination and extremely accurate touch in adjusting and repairing equipment and other devices.  Must be able to properly operate electronic and mechanical devices.

Physical Effort Required

Frequent walking and climbing of stairs and ladders, intermittent stooping, bending and crawling while making repairs to equipment, steady muscular exertion demanding considerable strength, able to lift 100 lbs. Strength: Heavy; Push: Occasionally; Pull: Occasionally; Carry: Occasionally; Lift: Occasionally; Sit: Occasionally; Stand: Frequently; Walk: Frequently

Personal Information

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Referral Information

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Placement Information

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High School

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Graduate School

Vocational School/ Other

Certifications / Licenses

License 1

License 2

License 3

License 4

Skills & Qualifications

Employment History

Current Employer

Previous Employer 1

Previous Employer 2


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Reference 1

Reference 2

Reference 3

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