Employee Application

Employee Application

Select Service Electric | 405-598-7051 | P.O. Box 705 Tecumseh, OK 74873 | Info@selectserviceelectric.com
Personal Information
Last Name
First Name
Middle Name
Date of Application

MonthDayYear
Date
Street Address
City
State
Zip
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Birth Date

MonthDayYear
Date
Position & Availability
Position Desired
Apprentice, Residential Journeyman, Unlimited Journeyman, Foreman
Rate Desired
Per Hour
Hours per week
Evenings/Nights available
Employment Desired
Start date

MonthDayYear
Date
Background
Felony conviction
Explanation
Education
School (High School)
Location (High School)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Graduation Year
Location (Business/Trade School)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
School (College)
Location (College)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Major (College)
Years Completed (College)
Degrees/Certificates (College)
School (Business/Trade School)
Years Completed (Business/Trade School)
Degrees/Certificates (Business/Trade School)
Skills
Languages

Other
US work eligibility
Previous employment
Previous employment dates

MonthDayYear
Date
Qualifications Summary
Employment History
Employer Name 1
Address 1

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Permission 1
Explanation 1
Supervisor’s Name 1

First NameMiddle NameLast Name
Phone Number 1
Please enter a valid phone number.Format: (000) 000-0000.
Employment Dates 1

MonthDayYear
Date
Present 1
Salary Start 1
Salary Final 1
Duties/Skills/Promotions 1
Reason for Leaving 1
Employer Name 2
Address 2

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Permission 2
Explanation 2
Supervisor’s Name 2

First NameMiddle NameLast Name
Phone Number 2
Please enter a valid phone number.Format: (000) 000-0000.
Employment Dates 2

MonthDayYear
Date
Present 2
Salary Start 2
Salary Final 2
Duties/Skills/Promotions 2
Reason for Leaving 2
References
Reference 1 - Name

First NameMiddle NameLast Name
Reference 1 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 1 - Telephone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 - Relationship Description
Reference 2 - Name

First NameMiddle NameLast Name
Reference 2 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 2 - Telephone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 - Relationship Description
Reference 3 - Name

First NameMiddle NameLast Name
Reference 3 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 3 - Telephone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 - Relationship Description
Military Service
Armed Forces
Branch
Specialty
Dates

MonthDayYear
Date
Discharge
Authorization
Applicant Name

First NameMiddle NameLast Name
Signature
Signature Date

MonthDayYear
Date
How did you hear about us?
Should be Empty:

Employee Application

Personal Information

Position & Availability

Background

Education

Skills

Employment History

References

Military Service

Authorization