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East Central Electric Inc.
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Job Application
First Name
Last Name
Email
Home Address
Apartment/Unit #
City
State
ZIP Code
Phone
Secondary Phone
Date
Desired Salary
Desired Position
Are you a citizen of the United States?
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
Yes
No
If yes, when?
Have you ever been convicted of a felony?
Yes
No
If yes, explain:
High School
Address
From:
To:
Did you graduate?
Yes
No
Diploma
College
Address
From:
To:
Did you graduate?
Yes
No
Degree
Other
Address
From:
To:
Did you graduate?
Yes
No
Degree
Previous Employment
Phone
Address
Supervisor
Job Title
Starting Salary:
Ending Salary:
Responsibilities
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Yes
No
Previous Employment
Phone
Address
Supervisor
Job Title
Starting Salary:
Ending Salary:
Responsibilities
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Yes
No
Military Service Branch
From:
To:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature:
Date:
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