T5
TELCOM PROFESSIONAL SERVICES
Please complete all sections clearly and accurately. Include any relevant D.C. power, telecom, battery plant, grounding, testing, safety, and travel experience. If a question does not apply, write N/A.
Applicant Information
Full Name:
Address:
City, State, ZIP:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Date Available:
-
Month
-
Day
Year
Date
Desired Pay:
Position Information
Position Applied For: D.C. Power Installer
Employment Desired:
Full-Time
Part-Time
Temporary
Willing to Travel: Yes
No
Shift Availability:
Day
Night
Weekend
On-Call
Valid Driver's License:
Yes
No
Reliable Transportation:
Yes
No
Are you legally authorized to work in the country?
Yes
No
Are you at least 18 years old?
Yes
No
Have you worked for this company before?
Yes
No
If yes, when?
Technical Qualifications
Years of D.C. Power / Telecom Installation Experience:
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Experience With: Rectifiers
Batteries
BDFBs/Distribution
Inverters
Grounding
Testing
Work Environments: Central Office
Data Center
Cell Site
Equipment Shelter
Industrial
Can you read prints, schematics, and wiring diagrams?
Yes
No
Installation Skills: Cable Routing
Terminations
Lacing
Labeling
Equipment Rack / Bay Installation
Have you performed live power work, cutovers, or work under change control procedures?
Yes
No
Explain:
Tools / Test Equipment Used: Multimeter
Clamp Meter
Battery Tester
Hydraulic
Crimper
Hand Tools
Safety and Certifications
OSHA 10
OSHA 30
CPR / First Aid
NFPA 70E
Forklift
Other:
Battery, Grounding, or Telecom Power Training Completed:
Can you meet physical demands such as lifting equipment, working on ladders, and working in confined or active equipment spaces?
Yes
No
Education
Education
Rows
Location
Years Attended
Degree/Diploma
High School
College
Trade School / Apprenticeship
Other
Employment History
Employer 1
Employer Name
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Job Title / Supervisor
Phone / Dates Employed
Address
DC power, batteries, grounding, cabling, testing, cutovers, documentation
Reason for Leaving
May We Contact This Employer?
Yes
No
Employer Name
Job Title / Supervisor
Phone / Dates Employed
Address
DC power, batteries, grounding, cabling, testing, cutovers, documentation
Reason for Leaving
References
References
Rows
Relationship
Company
Phone
Email
Reference 1
Reference 2
Reference 3
Additional Information
Travel Availability / Preferred Work Region
Trade Skills, Certifications, Licenses, or Equipment Experience
Emergency Contact Name and Phone
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Next
Applicant Statement
I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that false or misleading information may result in disqualification from consideration or termination of employment.
Applicant Signature:
Date:
-
Month
-
Day
Year
Date
For Office Use Only:
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