Rocks Electric Application Form

Job Application

Please complete the form below to apply for a position with us.
Full Name*

First NameMiddle NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Phone Number*

Area CodePhone Number
Position Applying For*
Date Available*

MonthDayYear
Desired Salary*
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Are you a citizen of the United States?*

YesNo
If no, are you authorized to work in the U.S.?*

YesNo
Have you ever worked for this company?*

YesNo
If yes, explain
Do you have a valid Drivers License?*

YesNo
Any restrictions?*
Do you have a CDL?*

YesNo
Have you ever been convicted of a felony?*

YesNo
If yes, explain
Education
High School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From-To*
Did you graduate?*

YesNo
College*
Degree*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you graduate?*

YesNo
Other
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you graduate?

YesNo
Degree
Previous Employment
Company 1
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Supervisor Name
Starting Salary $
Ending Salary $
Responsibilities
From:

MonthDayYear
To:

MonthDayYear
Reason for leaving:
May we contact your previous supervisor for a reference?

YesNo
Company 2
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Supervisor Name
Starting Salary $
Ending Salary $
Responsibilities
From:

MonthDayYear
To:

MonthDayYear
Reason for leaving
May we contact your previous supervisor for a reference?

YesNo
Company 3
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Supervisor Name
Starting Salary $
Ending Salary $
Responsibilities
From:

MonthDayYear
To:

MonthDayYear
Reason for leaving
May we contact your previous supervisor for a reference?

YesNo
Military Service
Branch
From - To
Rank at Discharge
Type of Discharge
If other than honorable, explain
Additional Questions
Are you a licensed master electrician?*

YesNo
Are you a licensed journeyman electrician?*

YesNo
Are you a registered apprentice electrician?*

YesNo
Are you able to lift 75 Pounds on a regular basis?*

YesNo
Do you have a driver’s license? (or are you able to obtain one)

YesNo
Do you have a CDL driver’s license?

YesNo
Do you have forklift experience?*

YesNo
Do you have trencher experience?*

YesNo
Do you have tractor experience?*

YesNo
Do you have experience running a scissor lift?*

YesNo
Do you have experience using a boom truck?*

YesNo
Do you have experience running a skid steer?*

YesNo
Are you able to read blueprints?*

YesNo
Are you able to weld?*

YesNo
Are you willing to take a pre-employment drug test?*

YesNo
Do you have a current Department Of Transportation medical card?*

YesNo
List other power or specialty tools that you have experience using:
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*

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Job Application

Education

Previous Employment

Military Service

Additional Questions

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