KC Electrical Services, Inc. Employment Application

Employment Application

Applicant Information:
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Format: (000) 000-0000.
Email
example@example.com
Date Available

MonthDayYear
Date
Desired Salary
Position Applied for
Are you a citizen of the United States?

YesNo
If No, are you authorized to work in the U.S.?

YesNo
What legal document can you provide as proof of citizenship or legal status?
Have you ever been convicted of a felony?

YesNo
If yes, please explain:
Education
High School
City, State
From

MonthDayYear
Date
To:

MonthDayYear
Date
Did you Graduate?

YesNo
Trade School
City, State
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Did you graduate?

YesNo
Degree
College
City, State
From

MonthDayYear
Date
To:

MonthDayYear
Date
Did You Graduate?

YesNo
Degree
References
Full Name
Company
Address
Phone
Format: (000) 000-0000.
Relationship
Full Name
Company
Address
Phone
Format: (000) 000-0000.
Relationship
Full Name
Company
Address
Phone
Format: (000) 000-0000.
Relationship
Previous Employment
Company
Address
Phone
Format: (000) 000-0000.
Supervisor
Job Title & Responsibilities
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving
Starting Salary: $
Ending Salary: $
May we contact your previous supervisor for a reference?

YesNo
Company
Address
Phone
Format: (000) 000-0000.
Supervisor
Job Title & Responsibilities
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving
Starting Salary:$
Ending Salary:$
May we contact your previous supervisor for a reference?

YesNo
Company
Address
Phone
Format: (000) 000-0000.
Supervisor
Job Title & Responsibilities
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving
Starting Salary:$
Ending Salary:$
May we contact your previous supervisor for a reference?

YesNo
Military Service
Military Branch
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Rank at Discharge
What military skills do you possess that would be an asset for this position?
Licensing / Trade
State Licensing Bureau
Trade License Type
License Number
Trade License Expiration Date

MonthDayYear
Date
Driver's License state
Driver's License Number
Provide a list of moving violations and at fault accidents obtained in the last three years
By submitting this application, I certify that my answers are true and complete to the best of my knowledge. The relationship between you and KC Electrical Services, Inc. is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you, or KC Electrical Services, Inc. No representative of KC Electrical Services, Inc. has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Company's Vice-President or President.
DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Your Name
Should be Empty: