Employment Application by powerconceptsadmin | Sep 6, 2018 Apply Online *Name*Email*Address*PhoneReferral 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-Employment 1:--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.