Employee Application - BLM&C Electrical Corporation

Step 1 of 6 - GENERAL INFORMATION

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Name*

First Middle Last

Address*

Street Address City State ZIP Code

Phone*

Best Time To Call*

AM/PM

Alternate Phone

Email Address*

Are you over 18 years of age?*

Yes

No*

*If no, you may be required to provide authorization to work.

Are you legally eligible to work in the United States?*

Yes

Position Desired*

Electrician

Apprentice

Other

Salary Desired $*

Date Available To Start*

MM slash DD slash YYYY

Availability*

Full Time

Part Time

Can you perform the essential functions of the position for which you are applying?*

If you have any question as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question.

Yes

Please Explain*

Are you currently employed?*

Yes

May we contact your present employer?*

Yes

Why are you considering leaving?*

Do you have a valid driver’s license?*

Yes

Do you have reliable transportation?*

Yes

Starting with the most recent

Employer*

Supervisor’s Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Job Title*

Reason For Leaving*

Dates of Employment*

from

MM slash DD slash YYYY

Dates of Employment*

MM slash DD slash YYYY

Add Another Employer*

Employer*

Supervisor’s Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Job Title*

Reason For Leaving*

Dates of Employment*

from

MM slash DD slash YYYY

Dates of Employment*

MM slash DD slash YYYY

Add Another Employer*

Employer*

Supervisor’s Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Job Title*

Reason For Leaving*

Dates of Employment*

from

MM slash DD slash YYYY

Dates of Employment*

MM slash DD slash YYYY

High School

Name Of School*

Location*

Number of Years Completed*

Major & Degree*

College

College*

Name Of School*

Location*

Number of Years Completed*

Major & Degree*

Graduate School

Graduate School*

Name Of School*

Location*

Number of Years Completed*

Major & Degree*

Bus. or Trade School

Bus. or Trade School*

Name Of School*

Location*

Number of Years Completed*

Major & Degree*

Professional School

Professional School*

Name Of School*

Location*

Number of Years Completed*

Major & Degree*

Are you a veteran of the U.S. Military service?*

Yes

Have you completed any special courses, seminars and/or training directly related to the position for which you are applying?*

Yes

Please Describe*

Do you belong to any professional, trade, business or civic organizations that relate to the position for which you are applying?*

Yes

Please Explain and List Offices Held*

Omit any which may reflect your race, color, religion, age, gender, sexual orientation, marital status, or disabilities.

Have you ever done any volunteer work?*

Yes

Describe*

Omit any which may reflect your race, color, religion, age, gender, sexual orientation, marital status or disabilities.

Give three references (not relatives or employers)

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Occupation*

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Occupation*

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Occupation*

Resume

Max. file size: 512 MB.

IMPORTANT, PLEASE READ AND AGREE*

Yes, I understand.

I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can result in disqualification for employment consideration or, if hired, may be grounds for termination from the company or its' subsidiaries. I understand that if I am hired, my employment is for no definite time and may be terminated at any time without prior notice.

Name

This field is for validation purposes and should be left unchanged.