Kelly Electrical Contractors, Inc.

Kelly Electrical Contractors, Inc. - Woodbury based full-service electrical contractor

Job Application form




Contact Information

First Name	Last Name	Email

Street Address		Apartment, Suite Unit #

City	State	Zip Code


Home Phone	Work Phone	Cell Phone

Schooling

High School		Graduation Year


College		Graduation Year


Trade School		Graduation Year


Apprenticeship Started?		Completed?


Electrical Background

How many years have you been in the electrical field? (working for a real electrical company.)


Is this verifiable time? (can we call your past companies to confirm?)
yes no

Please provide a rough breakdown of your time in each of the following trade areas:

Residential	Commercial	Industrial

Celluler


What area do you enjoy most?
A - 1st preference
B - 2nd preference
C - 3rd preference
D - 4th preference

Special Skills or training:

Work History (most current first) 3 references

Employer #1	Approx. Start date	Last date of employment

Street Address		Contact

City	State	Phone


Reason for leaving	Starting pay/Ending pay	May we contact? yes no


Employer #1	Approx. Start date	Last date of employment

Street Address		Contact

City	State	Phone


Reason for leaving	Starting pay/Ending pay	May we contact? yes no


Employer #1	Approx. Start date	Last date of employment

Street Address		Contact

City	State	Phone


Reason for leaving	Starting pay/Ending pay	May we contact? yes no

Referral

How did you hear about us?


Personal References (other than family members)

Name #1

Street Address		Relationship to you

City	State	Phone


Name #2

Street Address		Relationship to you

City	State	Phone


Name #3

Street Address		Relationship to you

City	State	Phone


General

Do you have a valid driver's license?		yes no

Have you been convicted of felony in the past five years?		yes no

If yes, please explain (will not necessarily exclude you from consideration)


Authorization

I certify that the information contained in this application is true and complete to the best of my knowledge and I understand that if I am employed by Kelly Electrical Contractors, Inc. or Kelly Electric Residential, LLC., falsified statements on this application or in person will be grounds for dismissal. I authorize you to investigate all statements contained on this application and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from the utilization of such information

Name		Date

Signature

Contact information
781 Mantua Pike
Woodbury NJ 08096
Office: 856-853-0800
Fax: 856-853-7560
(no solicitation please)
kellyelectrical@comcast.net

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