Live Systems - Electrician Application For Employment

LIST THREE (3) PERSONAL REFERENCES NOT RELATED TO YOU:

(Include only Individuals familiar with your work ability)


Name
Years Known
Relationship
Address
Phone

(Include only Individuals familiar with your work ability)


Name
Years Known
Relationship
Address
Phone

(Include only Individuals familiar with your work ability)


Name
Years Known
Relationship
Address
Phone

Notify in case of Emergency
Phone
DRUG AND ALCOHOL STATEMENT

Live Systems L.L.C. is committed to maintaining an alcohol and drug free work environment.

Because of the importance of safety, we take a strong stance against the possession or use of alcohol or illegal drugs on Live Systems L.L.C. time or jobsites.

I understand that should I be caught with or under the influence of alcohol or illegal drugs on Live Systems L.L.C. time or on any jobsite that I shall be subject to immediate termination.
Applicants Signature

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Date

MonthDayYear
Date
CRIMINAL BACKGROUND CHECK AUTHORIZATION AND RELEASE FORM
I, Type a label hereby authorize any law enforcement agency to furnish Live

Systems L.L.C. or its agent information related to my criminal history. I hereby release Live Systems L.L.C. and all of its agents and employees, the law enforcement agency and all employees of law enforcement agencies furnishing information, from all liability resulting from the furnishing of this information to Live Systems L.L.C. I certify that the statements made by me on this form are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that any false statements made herein will void my consideration for employment / continued employment, and could result in disciplinary action, including termination.
Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Signature

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Date

MonthDayYear
Date

EXPERIENCE INFORMATION - QUALIFIED IN THE FOLLOWING


Residential Wiring
Commercial Wiring
Industrial Wiring
Service Technician
Fire Alarm Systems
Security Systems
High Voltage
Voice / Data
Fiber Optic
Automation Controls
Lighting Protection
Audio / Visual

OTHER
ACTUAL ELECTRICAL CONSTRUCTION EXPERIENCE
LIST OF OSHA TRAINING YOU HAVE DOCUMENTATION FOR
LIST OF OSHA TRAINING YOU HAVE DOCUMENTATION FOR

EMPLOYMENT HISTORY
EMPLOYMENT HISTORY
EMPLOYER (# 1)
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATE OF EMPLOYMENT (From)

MonthDayYear
From
To

MonthDayYear
JOB TITLE / CLASSIFICATION
SUPERVISOR
REASON FOR LEAVING

WORK PERFORMED


Residential Wiring
Commercial Wiring
Industrial Wiring
Service Technician
Fire Alarm Systems
Security Systems
High Voltage
Voice / Data
Fiber Optic
Automation Controls
Lighting Protection
Audio / Visual

OTHER

EMPLOYMENT HISTORY (Continued)
EMPLOYMENT HISTORY
EMPLOYER (# 2)
PHONE
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATE OF EMPLOYMENT (From)

MonthDayYear
From
To

MonthDayYear
JOB TITLE / CLASSIFICATION
SUPERVISOR
REASON FOR LEAVING

WORK PERFORMED


Residential Wiring
Commercial Wiring
Industrial Wiring
Service Technician
Fire Alarm Systems
Security Systems
High Voltage
Voice / Data
Fiber Optic
Automation Controls
Lighting Protection
Audio / Visual

OTHER

EMPLOYMENT HISTORY (Continued)
EMPLOYMENT HISTORY
EMPLOYER (# 3)
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATE OF EMPLOYMENT (From)

MonthDayYear
From
To

MonthDayYear
JOB TITLE / CLASSIFICATION
SUPERVISOR
REASON FOR LEAVING

WORK PERFORMED


Residential Wiring
Commercial Wiring
Industrial Wiring
Service Technician
Fire Alarm Systems
Security Systems
High Voltage
Voice / Data
Fiber Optic
Automation Controls
Lighting Protection
Audio / Visual

OTHER

EMPLOYEE RELEASE AND PRIVACY STATEMENT
I understand that Live Systems L.L.C. requires certain information about me to evaluate my qualifications for employment. Therefore, I authorize Live Systems L.L.C. to investigate my past employment, educational credentials and other employment-related activities and reference checks.

I understand that any false or incomplete answers, statements or omission of facts made by me on this application or any supplement will be sufficient grounds for immediate termination, if I am employed.

I understand, if hired, that I am employed at will and that my employment and compensation can be terminated with or without cause, and with or without notice, at any time by either myself or Live Systems L.L.C.
Applicants Signature

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Date

MonthDayYear
Date
INTERVIEWERS NOTES
DATE INTERVIEWED

MonthDayYear
Date
DATED HIRED

MonthDayYear
Date
MANAGERS SIGNATURE

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ELECTRICIAN APPLICATION FOR EMPLOYMENT

LIST THREE (3) PERSONAL REFERENCES NOT RELATED TO YOU:

CRIMINAL BACKGROUND CHECK AUTHORIZATION AND RELEASE FORM

EDUCATION INFORMATION

EXPERIENCE INFORMATION - QUALIFIED IN THE FOLLOWING

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY (Continued)

EMPLOYMENT HISTORY (Continued)

EMPLOYEE RELEASE AND PRIVACY STATEMENT