Employment Application Form - Prairie Electric

Applicant Information

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Have you ever been employed with us before:(Required)

Yes

No

Best time to contact you at home is:(Required)

:

Position Applied for:(Required)

Please see our Careers page for current openings.

Write-in position

Desired Location(Required)

How did you hear about us?(Required)

Other, please explain

Are you over the age of 18 years?(Required)

Yes

No

(If no, you may be required to provide authorization to work.)

Have you ever filled out an application with us before?(Required)

Yes

No

If yes, give a date

Are you currently employed?(Required)

Yes

No

May we contact your employer?

Yes

No

Are you legally eligible to be employed in the United States?(Required)

Yes

No

(Proof of identity and eligibility will be required upon employment)

Date available for work(Required)

Are you available to work(Required)

Full-time

Part-time

Temporary

Please indicate desired shift(s)

Mornings

Afternoon

Evenings

Please indicate dates available:

Are you currently on “Lay-off” status and subject to recall?(Required)

Yes

No

Can you travel if job requires it?(Required)

Yes

No

Employment Experience

Start with your present or last job. Include any job related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status.

Employer 1

Employer(Required)

Address(Required)

Telephone Number(s)(Required)

Job Title(Required)

Supervisor(Required)

Dates Employeed(Required)

Reason for Leaving(Required)

Employer 2

Employer

Address

Telephone Number(s)

Job Title

Supervisor

Dates Employeed

Reason for Leaving

Employer 3

Employer

Address

Telephone Number(s)

Job Title

Supervisor

Dates Employeed

Reason for Leaving

Employer 4

Employer

Address

Telephone Number(s)

Job Title

Supervisor

Dates Employeed

Reason for Leaving

Additional Employment Information

Additional employment history (if applicable)

List professional, trade, business, or civic activities and offices held.

You may exclude organizations that indicate race, color, religion, gender, national origin, disabilities, or other protected status.

References

References(Required)

Name

Phone

Company (if applicable) Position

Years Known

Applicant's Statement

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Digital Signature of Applicant(Required)

Date(Required)

Name

This field is for validation purposes and should be left unchanged.

Applicant Information

Education

Employment Experience

Employer 1

Employer 2

Employer 3

Employer 4

Additional Employment Information

References

Applicant's Statement