xElectrical Helper/Apprentice Job

Electrical Helper / Apprentice Job

First Name

Middle Name

Last Name

Mobile Phone

Home Phone

Email Address

Street Address

City

State

Zip Code

Type of employment desired?

Full-time

Part-time

Temporary

Seasonal

If under 18 and we require a work permit, can you furnish one?

Yes

No

Are you a citizen of the United States?

Yes

No

Have you ever pleaded "guilty" or "no contest" or been convicted of a crime?

Yes

No

NOTE: Answering "yes" doesn't constitute an automatic rejection for employment. Offense date, seriousness and nature of violation, rehabilitation and position applied for will be considered.

Available start date

Salary requirement

Driver's license number (if applicable)

Previous Employment Experience

Current or most recent employer

Address

Phone

Name of immediate supervisor

Position / Job Title

Employment Dates

Responsibilities

Ending salary

Reason for leaving

May we contact for reference?

Yes

No

Prior employer #2

Address

Phone

Name of immediate supervisor

Position / Job Title

Employment Dates

Responsibilities

Ending salary

Reason for leaving

May we contact for reference?

Yes

No

Prior employer #3

Address

Phone

Name of immediate supervisor

Position / Job Title

Employment Dates

Responsibilities

Ending salary

Reason for leaving

May we contact for reference?

Yes

No

I certify my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

Signature (type your name)

Date

SUBMIT APPLICATION