Join Our Team – Powering the Future Together! Fill Out the Form Below to Get Started First Name Last Name Middle Name Address City/Town State/Province Zip/Postal Code Email Home Phone Mobile Phone Are you over the age of twenty-one? If you are not, hire is subject to verification that you are of minimum legal age. Are you over the age of twenty-one? If you are not, hire is subject to verification that you are of minimum legal age. Over 21 Are you a citizen of the United States of America? Are you a citizen of the United States of America? US Citizen DO YOU HAVE A VALID DRIVER'S LICENSE? DO YOU HAVE A VALID DRIVER'S LICENSE? Yes No DO YOU HAVE A COMMERCIAL DRIVER'S LICENSE? DO YOU HAVE A COMMERCIAL DRIVER'S LICENSE? Yes No Position(s) being applied for Hourly Wage Requested Job Status Applying For Job Status Applying For Full Time Part Time On What Date Could You Be Available For Work? List names of friends or relatives working for us Convictions - Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses. If so list them and if not then please place "none" in this box. Elementary School Name Elementary School Address Elementary School Last Year Completed Did You Graduate Elementary School? Did You Graduate Elementary School? Yes High School Name High School Address High School Last Year Completed Did You Graduate High School? Did You Graduate High School? Yes College Name College Address College Last Year Completed Did You Graduate College? Did You Graduate College? Yes Other Education Name Other Education Address Other Education Last Year Completed Did You Graduate? Did You Graduate? Yes Previous Employment 1 Name Of Company Previous Employment 1 Address Previous Employment 1 Start Date Previous Employment 1 End Date Previous Employment 1 Job Description Previous Employment 1 Salary Previous Employment 1 Reason For Leaving Previous Employment 2 Name Of Company Previous Employment 2 Address Previous Employment 2 Start Date Previous Employment 2 End Date Previous Employment 2 Job Description Previous Employment 2 Salary Previous Employment 2 Reason For Leaving Previous Employment 3 Name Of Company Previous Employment 3 Address Previous Employment 3 Start Date Previous Employment 3 End Date Previous Employment 3 Job Description Previous Employment 3 Salary Previous Employment 3 Reason For Leaving Other Skills & Experience Reference 1 Name Reference 1 Address Reference 1 Phone Number Reference 2 Name Reference 2 Address Reference 2 Phone Number Reference 3 Name Reference 3 Address Reference 3 Phone Number Lineman work is very physical. To peform this work you will have to demonstrate several physical abilities essential to Lineman work. These physical abilities are grip strength, upper and lower body muscular strength, muscular endurance, and aerobic capacity. The abilty to lift items of 112 lbs to a hight of 24 inches, lifting items weighing up to 74 lbs ovehead and climbing poles is essential to our work. By checking this box you are attesting that you physically and otherwise able to perform the duties of the job of which you are applying. Lineman work is very physical. To peform this work you will have to demonstrate several physical abilities essential to Lineman work. These physical abilities are grip strength, upper and lower body muscular strength, muscular endurance, and aerobic capacity. The abilty to lift items of 112 lbs to a hight of 24 inches, lifting items weighing up to 74 lbs ovehead and climbing poles is essential to our work. By checking this box you are attesting that you physically and otherwise able to perform the duties of the job of which you are applying. Physical Abilities The facts set forth above in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. I also understand that this application form will be maintained in the active files for one year only unless renewed. The facts set forth above in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. I also understand that this application form will be maintained in the active files for one year only unless renewed. I Attest to this Information Submit
