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Job Application

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
 

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