Georgetown: (978) 352-4937  |  Newburyport: (978) 462-0553  |  Haverhill: (978) 372-3641
Peabody: (978) 531-2220  |  Hampton: (603) 964-6206  |  Seabrook: (603) 474-7799

Employment Application

Simmons Plumbing & HVAC serves the lower Merrimack Valley and Seacoast of NH and Maine. We are always seeking motivated individuals with industry experience, or those who are seeking to learn new trade skills. We provide competitive wages and a generous benefits package.

Simmon Plumbing & HVAC is an equal opportunity employer. Women and minorities are encouraged to apply.

Fields marked with * are required in order to submit the form.

 Applicant Information 






 Additional Information 
Are you 18 years of age or older? 


Are you a U. S. citizen? 

If no, please choose one of the following: 




Do you have a valid driver's license? 






Our company does DMV, pre-employment criminal background checks & drug testing. Is there anything we need to be made aware of? 



Have you ever been convicted or pled guilty or no contest to any criminal offense? 



Please note that criminal convictions are not an automatic disqualification to employment but are considered only in relation to specific job requirements.
 Position & Availability 
Which position(s) are you interested in:











Are you available to work 


Are you available to work evenings, if needed? 

Are you available to work Saturdays, if needed? 

Are you available to work Sundays and holidays, if needed? 

 Experience 
Are you an Installation Technician?  

Are you a Service/Maintenance Technician? 

Are you an Electrician? 

Are you a Plumber? 

Do you have Residential or Commercial HVAC Sales experience? 



Do you have Call Center / Dispatch experience? 



 Current Employment 
Are you currently employed?  

If yes, may we contact your supervisor? 

The following information will assist us in doing reference checks. Please provide details of your work history in the spaces that follow. Fill in these spaces carefully and completely. Begin with your current job and work back.











Please provide us the names and addresses of your last three employers:

 Employer #1 








 Employer #2 








 Employer #3 








 Other Employment Information 





Our company does DMV, pre-employment criminal background checks and drug testing. Is there anything we need to be made aware of? 



Have you ever been convicted or pled guilty or no contest to any criminal offense? 



 Education 

Are you EPA certified? 

Are you NATE certified? 



 Special Skills 
Do you have computer skills? 



Do you speak fluently in any language other than English?  



Verbal Skills?  

Written Skills? 

Please provide us with the following information for references:

 Reference 1 

 Reference 2 

 Reference 3 

 Referrals 


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