Employment Application Form

Personal Information
Name:*

First NameLast Name
Birth Date

MonthDayYear
Phone Number:*

Area CodePhone Number
E-mail Address:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about to us?*

Walk-InEmployeeFacebookTwitterCraigslistFlyerOther
Others:
Job Skills & Training
Do you have any electrical experience?*

YesNo
If yes, in which do you have the most experience?

ResidentialCommercialIndustrialLIneman/Groundman
How much Electrical Experience do you have?*

0-1 years1-3 years4-7 years7-10 years10+ years
Describe your skills:
List Any Certifications (ie: OSHA, CPR, First Aid, etc.):
Upload Resume:
Previous Employers

Please list two (2) references that are familiar with your work life.
Employer 1
Company Name
Phone Number

Area CodePhone Number
Years Employed:
Employer 2
Company Name
Phone Number

Area CodePhone Number
Years Employed:
Should be Empty: