Rocks Electric Application Form

Job Application

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

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address *
Phone Number *

Area Code Phone Number
Position Applying For *
Date Available *

Month Day Year
Desired Salary *
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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, explain
Do you have a valid Drivers License? *

Yes No
Any restrictions? *
Have you ever been convicted of a felony?

Yes No
If yes, explain
Education
High School *
Address *

Street Address

Street Address Line 2

City State / Province

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

Yes No
College *
Degree *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Did you graduate? *

Yes No
Other
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Did you graduate?

Yes No
Degree
Previous Employment
Company 1
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Month Day Year
To:

Month Day Year
Reason for leaving:
May we contact your previous supervisor for a reference?

Yes No
Company 2
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Month Day Year
To:

Month Day Year
Reason for leaving
May we contact your previous supervisor for a reference?

Yes No
Company 3
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

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

Month Day Year
To:

Month Day Year
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
Additional Questions
Are you a licensed master electrician?

Yes No
Are you a licensed journeyman electrician?

Yes No
Are you a registered apprentice electrician?

Yes No
Are you able to lift 75 Pounds on a regular basis?

Yes No
Do you have a driver’s license? (or are you able to obtain one)

Yes No
Do you have a CDL driver’s license?

Yes No
Do you have forklift experience?

Yes No
Do you have trencher experience?

Yes No
Do you have tractor experience?

Yes No
Do you have experience running a scissor lift?

Yes No
Do you have experience using a boom truck?

Yes No
Do you have experience running a skid steer?

Yes No
Are you able to read blueprints?

Yes No
Are you able to weld?

Yes No
Are you willing to take a pre-employment drug test?

Yes No
Do you have a current Department Of Transportation physical or are you willing to get one?

Yes No
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

Disclaimer and Signature