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

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

Hours

Minutes

AM/PM

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

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

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

Yes

If yes, give a date

MM slash DD slash YYYY

Are you currently employed?(Required)

Yes

May we contact your employer?

Yes

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

Yes

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

Date available for work(Required)

MM slash DD slash YYYY

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

Can you travel if job requires it?(Required)

Yes

Education

High School(Required)

Name and Location of School

Course of Study

Number of Years Completed

Diploma / Degree

Trade School

Name and Location of School

Course of Study

Number of Years Completed

Diploma / Degree

Other (Specify)

Name and Location of School

Course of Study

Number of Years Completed

Diploma / Degree

College

Name and Location of School

Course of Study

Number of Years Completed

Diploma / Degree

Licensing Information (Please check all that apply):(Required)

Valid Driver’s License

CDL Class A

WA General Journeyman

OR General Journeyman

WA Residential Journeyman

OR Residential Journeyman

JATC Apprentice*

EMG Apprentice*

WA Trainee

First Aid CPR- Certified

Other*

JATC Apprentice Licensing Year

EMG Apprentice Licensing Year

Other, please specify

Describe any specialized training, apprenticeship, skills, or extra-curricular activities related to the position you're applying for.

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)

MM slash DD slash YYYY

Name

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