Job Openings for Service Electricians, Journeymen Electricians and Apprentices

Today's Date

Your Information

Name

First Middle Last

Maiden name if applicable.

Present Address

Street Address City State ZIP Code

How long have you lived at this address?

Phone

If under 18, please list age.

Have you ever been convicted of a crime?

Yes

If yes, please fill out this section.

Explain the number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Military

Have you ever been in the Armed Forces?

Yes

Are you now a member of the National Guard?

Yes

Information about your service history.

Speciality

Date Entered

Discharge Date

Work Experience - Current or Last Position

Please list your work experience for the last five years beginning with the most recent job held. If you were self-employed, provide firm name.

Name of Employer

Address of Employer

Street Address Address Line 2 City State ZIP Code

Name of Last Supervisor

Employment Start Date

Employment End Date

Reason for Leaving

Be specific.

Your Last Job Title

Starting Pay or Salary

Ending Pay or Salary

Describe this position in detail.

List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Work Experience - Previous Position

Please list additional work experience in the last five years.

Name of Employer

Address of Employer

Street Address Address Line 2 City State ZIP Code

Name of Last Supervisor

Employment Start Date

Employment End Date

Reason for Leaving

Be specific.

Your Last Job Title

Starting Pay or Salary

Ending Pay or Salary

Describe this position in detail.

List the jobs held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Transportation

Do you have a current valid driver's license?

Yes

Driver's license number

Driver's license state of issue

Driver's license expiration date

Type of driver's license held

Operator

Commercial (CDL)

Chauffer

What is your means of transportation to work?

Have you had any accidents in the last three years? If so, how many?

Have you had any moving violations in the last three years? If so, how many?

References

Please list two references other than relatives or previous employers.

Reference 1 Name

Reference 1 Position

Reference 1 Company

Reference 1 Address

Street Address Address Line 2 City State ZIP Code

Reference 1 Phone

Reference 2 Name

Reference 2 Position

Reference 2 Company

Reference 2 Address

Street Address Address Line 2 City State ZIP Code

Reference 2 Phone

Summary

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Job Application

Your Information

Position You're Seeking

Education

Military

Work Experience - Current or Last Position

Work Experience - Previous Position

Transportation

References

Summary

(970) 945-6500

(970) 249-1719

(303) 653-7232