Employment Application Form

Personal Information
Name: *

First Name Last Name
Birth Date

Month Day Year
Phone Number: *

Area Code Phone Number
E-mail Address: *
Address: *

Street Address

Street Address Line 2

City State / Province

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

Walk-In Employee Facebook Twitter Craigslist Flyer Other
Others:
Job Skills & Training
Do you have any electrical experience? *

Yes No
If yes, in which do you have the most experience?

Residential Commercial Industrial LIneman/Groundman
How much Electrical Experience do you have? *

0-1 years 1-3 years 4-7 years 7-10 years 10+ 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 Code Phone Number
Years Employed:
Employer 2
Company Name
Phone Number

Area Code Phone Number
Years Employed:
Should be Empty: