PERSONAL INFORMATION
Name
Last
First
Middle
Current Address:
Street and Number
City
State
Zip
Phone Number:
Day
Evening
Position Desired:
Are you over 18 years of age?
Date of Birth
Are you legally authorized to work in the United States?
Do you have any relatives at MARKARIAN ELECTRIC, LLC?
If yes, Who?
Have you ever been employed by MARKARIAN ELECTRIC LLC?
If yes, When?
Do you have any specific salary requirement?
If yes, please indicate:
EMPLOYMENT INFORMATION
Date Available For Work:
Total Hours Available Per Week:
Could you work overtime if necessary?
Are there any days or hours you are unable or unwilling to work? If yes, please specify:
Do you have transportation to/from work?
Are you willing to travel?
EDUCATION
High School or Trade School:
Name
City
State
College or Trade School:
Name
City
State
Academic Awards, honors, or special recognition:
Extracurricular Activities:
Other night school, correspondence, home study or courses not listed above:
LICENSE INFORMATION
Are you licensed for the type of work applied for?
Licensed As:
State(s) of:
License Number:
Expiration Date:
Restrictions:
EMPLOYMENT RECORD INFORMATION
1. Current/Last Employer:
Employment Dates:
Type of Business:
Job Title:
Address with Phone Number:
Salary:
per
Supervisor:
Duties/Responsibilities:
Reason for Leaving:
2. Current/Last Employer:
Employment Dates:
Type of Business:
Job Title:
Address with Phone Number:
Salary:
per
Supervisor:
Duties/Responsibilities:
Reason for Leaving:
3. Current/Last Employer:
Employment Dates:
Type of Business:
Job Title:
Address with Phone Number:
Salary:
per
Supervisor:
Duties/Responsibilities:
Reason for Leaving:
Signature:
REFERENCES
Name:Date:
Position Applied For:
1. Name of Supervisor
Title:
Company Name and Address:
Company Phone Number including are code and extension:
2. Name of Supervisor
Title:
Company Name and Address:
Company Phone Number including are code and extension:
3. Name of Supervisor
Title:
Company Name and Address:
Company Phone Number including are code and extension:
1.Name and Address:
Phone Number including are code and extension:
Occupation
Years Acquainted:
How do you know this individual?
If yes, give details including date, location (city) nature offense and disposition.
SIGNATURE READ CAREFULLY BEFORE SIGNING: 1. I understand that the receipt of this application does not imply that I will be employed.
2. The statements and information furnished by me in this application are true and complete. I understand that I will be subject to immediate dismissal or refusal to hire if at any time MARKARIAN ELECTRIC, LLC discovers that I have omitted, misstated, or falsified information on this application or at any time during the hiring process.
3. I authorize MARKARIAN ELECTRIC, LLC to conduct a background inquiry to verify the statements and information on this application, and other documentation that I have provided, and other areas that may include prior employment, consumer credit, criminal convictions, motor vehicle history, and other reports. I authorize all previous employers or other persons who have knowledge of me, or my records, to release such information to MARKARIAN ELECTRIC, LLC. I hereby release any individual, agency, and MARKARIAN ELECTRIC, LLC from all claims or liabilities whatever that may arise from the disclosure of such information.
4. I understand that I may be required, depending on my position, to sign a non-complete, confidentiality, and/or business ethics agreement as a condition of my employment.
5. I understand that all employees of MARKARIAN ELECTRIC, LLC are employees at will. If hired, I will be free to resign at any time. Likewise, MARKARIAN ELECTRIC, LLC will have the right to terminate my employment at any time with or without any reason or notice, regardless of the date of payment of my wages or salary. Neither this application, the Safety Handbook, or any other documents given to me is intended to create, not should such document be construed as creating, and express or implied contract of employment for a definite term. I understand that no other company representatives have the authority to alter my at-will status without the written approval of MARKARIAN ELECTRIC, LLC Board of Directors.
My Signature Certifies That I Have Read and Agree with The Above Statements.
Signature of Applicant
If you are human, leave this field blank.
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