JOB APPLICATION

Applicant Information

Date *

Name *

First

Middle

Last

Address *

Address Line 1

City

State

Zip Code

Phone *

Email *

Date Available *

Social Security Number

Desired Weekly Salary *

What position are you applying for? *

Are you a United States citizen? *

Yes
No

If you answered No on the previous question, are you authorized to work in the United States?

Yes
No

Have you ever worked for A and V Electric in the past? *

Yes
No

If "Yes" when?

Have you ever been convicted of a felony? *

Yes
No

If "Yes" please explain....

Driving History

Do you have a Driver's License? *

Yes
No

Driver's License Number? * *

State where issued *

Endorsements/Restrictions

License Expiration Date *

Have you had any accidents in the past 3 years? *

Yes
No

Have you had any traffic violations in the past 3 years? *

Yes
No

Have you ever been cited for driving under the influence of alcohol or any banned substance? *

Yes
No

Education

Please indicate your highest level of education.

Please indicate your field of study.

High School/College/University Name

Diploma/Degree/Certification Name

Year of Graduation

Additional Certification, Licenses, Skills, and Qualifications

Professional References

Reference 1

Name

First

Last

Relationship

Company

Phone

Reference 2

Name

First

Last

Relationship

Company

Phone

Current and Previous Employment

Are you Currently Employed?

Yes
No

Most recent employer

Job Title

Supervisor First and Last Name

First

Last

Phone

Address

Address Line 1

City

State

Zip Code

Reason for leaving

May we contact your previous supervisor for a reference?

Yes
No

Previous Employer 1

Previous employer

Job Title

Supervisor First and Last Name

First

Last

Phone

Address

Address Line 1

City

State

Zip Code

Reason for leaving

May we contact your previous supervisor for a reference ?

Yes
No

Previous Employer 2

Previous Employer

Job Title

Supervisor First and Last Name

First

Last

Phone

Address

Address Line 1

City

State

Zip Code

Reason for leaving

May we contact your previous supervisor for a reference ?

Yes
No

Military Service

Have you ever served in the Military?

Yes
No

What Branch?

Honorable Discharge?

Yes
No

If "No" please explain....

Additional Information or Notes

Enter any additional information or notes.

Upload supporting documentation (Resume, Cover Letter, etc)

Disclaimer and Signature

Disclaimer *

By submitting this application and in exchange for the consideration of my job application by A and V Electric (hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of A and V Electric, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by an officer of the Company. Both the undersigned and A and V Electric may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies, and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contact. I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations. I further understand that my employment with the Company shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party. This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications. Your information on this Job Application is company confidential and will not be shared with anyone outside of the employment process.

Acknowledge *

I acknowledge that I have read the disclaimer above and the information within this application is true and correct.

Print your name *

Signature *

Date *

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