Pristine Job Application Form

Job Application Form
Personal Information
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is your social security number?*
Are you currently legally entitled to work in the country where the job is based?*

YesNo
If applicable, please detail any restrictions:
Position Information
Desired Position*
What is your desired employment?*
What is your desired pay?*
Hourly
What is your available start date?*

MonthDayYear
Date
Education
Highest Grade Completed*
High School or GED*
Year of Graduation*
Business School / College
Year of Graduation
Other formal training: (school, location, description)
List your work skills:*
Employment Status
Present Position or Status*
Are you presently under contract?*
If yes, until when?
Work Experience
References
Please list the names of three people not related to you, whom you have known for at least one year (recent employers preferred).*
Have you ever been convicted of a felony?*
Have you ever been dismissed or asked to resign from a position?*
If yes, please explain.
I hereby certify that the information herein is a true and complete statement of my personal and professional records to date. I am aware that any falsification on this application will constitute grounds for immediate dismissal. I give my permission to Pristine Electric to perform a criminal record background check.
Date*

MonthDayYear
Date
Signature*

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Job Application Form