Employment Application

Apply Online

*Name

*Email

*Address

*Phone

Referral Source:

News Papers     Radio     Online     Friend     Relative     Walk-In     Employment Agency    

Other Referral Source:

Position(s) Applied For:

Electrician     Security Technician     Clerical/Office Staff     Electrical Apprentice     Security Technician Assistant     Sales Associate    

Other Position Applied For:

Trade Licenses Held:

VA Apprentice     VA Journeyman     VA Masters     VA DCJS Installer     WV Apprentice     WV Journeyman     WV Masters     VA DCJS Sales     OSHA10    

Other Trade Licenses Held:

*Have you ever filed an application here before?

Yes     No    

*Are you employed now?

Yes     No    

If currently employed and you are under 18 years old, can you furnish a work permit?

Yes     No    

*Do you give permission for present and past employers to release information regarding your employment?

Yes     No    

*Are you prevented from Lawfully becoming employed in this country because of VISA or immigration status? (Proof of citizenship or immigration status will be required upon employment)

Yes     No    

*Have you been convicted of a felony or a misdemeanor in the last 7 years?

Yes     No    

If yes, explain:

*On what date are you available to start work?

*Are you available for work:

Full-Time     Part-Time    

*Are you on a layoff and subject to recall?

Yes     No    

*Can you travel if job requires it?

Yes     No    

EMPLOYMENT EXPERIENCE: Start with your most recent job Include military service assignments

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Employment 1:

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Employer:

Location:

Telephone Number:

Supervisor:

Job Title:

Work Performed:

Dates Worked From/To:

Salary:

Reason For Leaving:

- -

Employment 2:

- -

Employer 2:

Location 2:

Telephone Number 2:

Supervisor 2:

Job Title 2:

Work Performed 2:

Dates Worked From/To 2:

Salary 2:

Reason For Leaving 2:

- -

Employment 3:

- -

Employer 3:

Location 3:

Telephone Number 3:

Supervisor 3:

Job Title 3:

Work Performed 3:

Dates Worked From/To 3:

Salary 3:

Reason For Leaving 3:

- -

Employment 4:

- -

Employer 4:

Location 4:

Telephone Number 4:

Supervisor 4:

Job Title 4:

Work Performed 4:

Dates Worked From/To 4:

Salary 4:

Reason For Leaving 4:

Highest Education Level Achieved - School Name and Years Completed:

Diploma/Degree:

Describe course of study:

Give name, address, and telephone number of three references who are not related to you and are not previous employers:

Reference 1:

Reference 2:

Reference 3:

Additional Information:

Attach Resume:

Attach Licenses:

Attach Other:

*I certify that answers given herein are true and complete to the best of my knowledge I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision

Yes     No    

*I understand that this application is not and is not intended to be a contract of employment In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge

Yes     No    

*I understand also that I am required to abide by all rules and regulations of the Company

Yes     No    

Fields with (*) are required.