Step 1 of 6 0% Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. Attach more paper if you do not have enough room on this application. All information given will be available only to persons who have a “need to know” or as required by law. This company will make reasonable accommodation in the application process, if needed. Personal InformationName(Required) First Middle Initial Last U.S. Applicant Only: Are you legally eligible for employment in the U.S.?(Required)All new hires will be required to provide proof of eligibility to work in the U.S. Yes No Have you ever been convicted of a criminal offense?(Required)A conviction will not necessarily disqualify an applicant. Yes No Please explain:(Required) Are you over 18 years of age?(Required) Yes No Current Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Daytime PhoneEvening PhoneReferred by: Employment DesiredPosition(Required) Date You Can Start (mm/dd/yyyy)(Required) Month Day Year Salary Desired(Required) Are You Currently Employed?(Required) Yes No May we contact your current employer?(Required) Yes No Which type of Employment are you seeking:(Required) Full-Time Part-Time Temporary or Summer Education HistoryEducation History(Required)High School, College, Other Job-Related Education (Click the + button to add a new row)LevelSchool Name/LocationYears AttendedDid you graduate?Area of Study Add RemoveList skills relevant to the position applied for:(Required)Do you have a valid driver’s license?(Required) Yes No License Number and State Issued(Required) If you are an experienced operator of any business/plant machines or equipment, please list:(Required)Computer Proficiency:(Required) Microsoft Word Microsoft Excel Other Please explain:(Required) Record of EmploymentName of Current/Most Recent Employer(Required) Type of Business(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Dates Employed(Required)Month/Year to Month/Year Rate of Pay(Required)Starting to Ending Reason for Leaving(Required) Supervisor's Name and Title(Required) List the jobs you held, duties performed, skills used or learned, advancements or promotions.(Required)Do you have additional employment history?(Required) Yes No Name of Next Previous Employer(Required) Type of Business(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Dates Employed(Required)Month/Year to Month/Year Rate of Pay(Required)Starting to Ending Reason for Leaving(Required) Supervisor's Name and Title(Required) List the jobs you held, duties performed, skills used or learned, advancements or promotions.(Required)Do you have additional employment history?(Required) Yes No Name of Next Previous Employer(Required) Type of Business(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Dates Employed(Required)Month/Year to Month/Year Rate of Pay(Required)Starting to Ending Reason for Leaving(Required) Supervisor's Name and Title(Required) List the jobs you held, duties performed, skills used or learned, advancements or promotions.(Required)Do you have additional employment history?(Required) Yes No Name of Next Previous Employer(Required) Type of Business(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Dates Employed(Required)Month/Year to Month/Year Rate of Pay(Required)Starting to Ending Reason for Leaving(Required) Supervisor's Name and Title(Required) List the jobs you held, duties performed, skills used or learned, advancements or promotions.(Required) ReferencesProfessional References(Required)Give below the names of 3 professional references, who you have known for at least 1 year. (Click the + button to add a new row)NameAddressPhoneBusinessYears Known Add RemovePersonal References(Required)Give below the names of 3 personal references, who you have known for at least 1 year. (Click the + button to add a new row)NameAddressPhoneBusinessYears Known Add Remove Additional Information Attach any additional information. If applying for the Summer Lineman Internship Program, please attach a resume, school transcript, and cover letter. Resume Upload(Required)Please attach resume Drop files here or Select files Max. file size: 300 MB. Cover Letter Upload(Required)Please attach cover letter Drop files here or Select files Max. file size: 300 MB. Member Signature & ConsentMember Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.This Employment Application is used to notify me that the nature and scope of an investigation, if one is conducted, could include such general identification information as residence verification, and, as applicable, information concerning my employment, education, general reputation, character, personal characteristics, and habits, and that such information may be developed through personal interviews with third parties such as family members, neighbors, friends, associates, former employers, educational institutions, custodians of official records or other sources. Only job-related information developed from such a report will be considered in evaluating my employment application or continued employment. I hereby authorize these persons, companies, organizations, or corporations to answer all questions or release any information regarding the items listed in this paragraph. I hereby release them from any liability and hold them harmless from any claim for releasing any truthful information within their knowledge and/or records. I authorize the Company to release to any person, firm, entity, or organization with which I may seek employment in the future, any truthful information concerning my work experience with the Company. I hereby release and hold the Company harmless from any claim for releasing any truthful information within its knowledge and/or records. I understand that any job offer that may be extended to me will be contingent upon the successful completion of a drug and alcohol test. I certify that the answers given by me to the foregoing questions and during any interviews are true and correct without consequential omissions, and understand that, if employed, omissions and/or false statements on this application or during any interviews may result in dismissal. I understand and acknowledge that, if hired, my employment is for no definite period, and either the Employer or I may terminate our relationship at will at any time, without notice or any reason, and that this employment application does not constitute an employment contract. I have had an opportunity to have my questions about this statement's content and intent answered and understand its terms.Member Electronic Signature (Full Name)(Required) CommentsThis field is for validation purposes and should be left unchanged.
