Edmonson Electric

APPLICATION FOR EMPLOYMENT

Valid for 30 days

Edmonson Electric, Inc. is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, religion, national origin, disability, or marital status. We assure you that your opportunity for employment with Edmonson Electric, Inc. depends upon your qualifications, valid Florida Drivers License, and Background Search.

 

Note: This application was designed to be used with several types of job openings. Some questions may not be completed applicable to the position you are seeking.

EQUAL OPPORTUNITY EMPLOYER

Please answer all questions: Resumes are not accepted in place of application

DRUG-FREE WORKPLACE

LAST NAME                         FIRST NAME                       MIDDLE

SOCIAL SECURITY #

DATE

PRESENT STREET ADDRESS

CITY/STATE

ZIP CODE

TELEPHONE NUMBER

DATE OF BIRTH

POSITION APPLYING FOR

DATE YOU ARE AVAILABLE

ARE YOU 18 YEARS OF AGE OR OLDER?

  YES

  NO (PLEASE STATE YOUR AGE IF UNDER 18  )

DO YOU HAVE A VALID FLORIDA DRIVERS LICENSE?

  YES

  NO (PLEASE ENTER DL NUMBER  )

DO YOU HAVE RELIABLE TRANSPORTATION TO AND FROM OUR OFFICE?

  YES

  NO

ARE YOU WILLING TO WORK OVERTIME IF NECESSARY?

  YES

  NO

HAVE YOU EVER BEEN EMPLOYED BY US?

IF SO, WHEN ( )

AT WHAT LOCATION ( )

  YES

 

  NO

 

ONLY U.S. CITIZENS OR ALIENS WHO HAVE LEGAL RIGHT TO WORK IN THE U.S. ARE ELIGIBLE FOR EMPLOYMENT. CAN YOU, UPON EMPLOYMENT, SUBMIT DOCUMENTATION VERIFYING YOUR LEGAL RIGHT IN THE U.S. AND YOUR IDENTITY?   YES  NO

HAVE YOU EVER BEEN CONVICTED OF A FELONY OR FIRST-DEGREE MISDEMEANOR?                               YES  NO

IF YES, PLEASE EXPLAIN WHAT CHARGES.
WHERE WERE YOU CONVICTED, AND WHAT WAS THE DATE?

EDUCATION

(MAY OR MAY NOT BE CONSIDERED DEPENDING ON THE JOB APPLIED FOR)

NAME OF SCHOOL

(LAST SCHOOL FIRST)

ADDRESS

# OF YEARS ATTENDED

FIELD OF STUDY

DIPLOMA / DEGREE

 

I HEREBY ATTEST THAT ALL INFORMATION PROVIDED ON THIS EMPLOYMENT APPLICATION IS TRUE. IF IT IS DEEMED THAT ANY OF THE INFORMATION WAS OMITTED OR FALISIFIED AT ANY TIME, IT WILL LEAD TO DISCIPLINARY ACTION, INCLUDING TERMINATION.

 


  
 


 SIGNATURE (please type name to sign)                                                              DATE

 

 

EMPLOYMENT RECORD

 

(LIST THE JOBS YOU HAVE HELD BEGINNING WITH YOUR PRESENT OR LAST POSITION)

 

EMPLOYER:

SUPERVISOR:

EMPLOYER’S ADDRESS:

CITY:

STATE:

ZIP CODE:

DATES EMPLOYED:                                        START DATE END DATE

SALARY (HOURLY RATE):                            START SALARY END SALARY

POSITION HELD:

WORK PERFORMED:

REASON FOR LEAVING:

 

EMPLOYER:

SUPERVISOR:

EMPLOYER’S ADDRESS:

CITY:

STATE:

ZIP CODE:

DATES EMPLOYED:                                        START DATE END DATE

SALARY (HOURLY RATE):                            START SALARY END SALARY

POSITION HELD:

WORK PERFORMED:

REASON FOR LEAVING:

 

EMPLOYER:

SUPERVISOR:

EMPLOYER’S ADDRESS:

CITY:

STATE:

ZIP CODE:

DATES EMPLOYED:                                        START DATE END DATE

SALARY (HOURLY RATE):                            START SALARY END SALARY

POSITION HELD:

WORK PERFORMED:

REASON FOR LEAVING:

 

EMPLOYER:

SUPERVISOR:

EMPLOYER’S ADDRESS:

CITY:

STATE:

ZIP CODE:

DATES EMPLOYED:                                        START DATE END DATE

SALARY (HOURLY RATE):                            START SALARY END SALARY

POSITION HELD:

WORK PERFORMED:

REASON FOR LEAVING:

 

 

SPECIAL SKILLS AND QUALIFICATIONS

 

SUMMARIZE SPECIAL JOB RELATED SKILLS OR QUALIFICATIONS INCLUDING LICENSES AND CERTIFICATES ACCQUIRED FROM EMPLOYMENT OR TOHER EXPERIENCE THAT RELATES TO THE JOB YOU ARE APPLYING FOR.

INCLUDE REGISTRATION NUMBER, STATE AND EXPIRATION DATE.

 

SKILL/QUALIFIATION:

LICENSE / CERTIFICATE NUMBER:

STATE:

EXPIRATION DATE:

 

SKILL/QUALIFIATION:

LICENSE / CERTIFICATE NUMBER:

STATE:

EXPIRATION DATE:

 

SKILL/QUALIFIATION:

LICENSE / CERTIFICATE NUMBER:

STATE:

EXPIRATION DATE:

 

IN ORDER TO PERMIT A CHECK OF YOUR WORK AND EDUCATION REFERENCES, SHOULD WE BE MADE AWARE OF ANY CHANGE OF NAME OR ASSUMED NAME THAT YOU HAVE PREVIOUSLY USED?

 YES     NO                     IF YES, IDENDIFY THE NAMES AND RELEVANT DATES BELOW:

NAME:

RELEVANT DATE:

NAME:

RELEVANT DATE:

NAME:

RELEVANT DATE:

 

LIST ANY RELATIVES CURRENTLY EMPLOYED BY US BELOW:

 

NAME:

RELATIONSHIP:

NAME:

RELATIONSHIP:

NAME:

RELATIONSHIP:

 

REFERENCES

 

GIVE THE NAME, ADDRESS, TELEPHONE NUMBER, AND COMPANY NAME OF THREE REFERENCES WHO ARE NOT RELATED TO YOU AND ARE PREVIOUS EMPLOYERS

 

NAME

ADDRESS

TELEPHONE #

COMPANY NAME

 

GIVE THE NAME, TELEPHONE NUMBER, AND COMPANY NAME OF THREE REFERENCES NOT RELATED TO YOU.

 

NAME

TELEPHONE #

COMPANY NAME