Design Electric, Inc. Application for Employment

Design Electric, Inc. is currently accepting applicants to fill available positions.

To ensure proper consideration, please fill in the information below as completely and accurately as possible.

All statements made by applicants for employment on this form will be carefully checked for accuracy. We offer equal employment opportunities for all persons without regard to race, religion, sex, national origin, or handicap. The use of this form does not mean there are positions open and does not obligate us in any way.

Position Applying For *

Pay expected *

Have you worked for Design Electric, Inc. before? *

Start Date * +

End Date * +

Please provide reason for separation from employment *

How did you hear about Design Electric, Inc.? *

Choose Employee *

Current Employee

Previous Employee

Worked with Design Electric Inc. on a Job- Site

Company Truck

Choose Social Media *

Facebook

Instagram

Twitter

Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

Please answer the following questions.

Are you over the age of 18? *

Can you produce the necessary work certificate at the time of employment? *

Are you legally authorized to work in the United States? *

Valid Driver's licence? *

License # *

Expiration Date: * +

Has your license ever been suspended or revoked? *

Please explain. *

Have you ever been convicted of a crime EXCEPT for a minor traffic violation? *

Please explain. *

Have you ever been discharged or requested to resign from a position? *

Please explain. *

How much time have you lost from work during this past year? *

Why? *

Education and Certifications

High School graduate? *

High School Name and Location *

College Graduate? *

Years *

College Name and Location *

Degrees Awarded? *

VA Journeyman License? *

License # *

Expiration Date * +

VA Master License? *

License # *

Expiration Date * +

Out of State Journeyman License? *

License # *

Expiration Date * +

Out of State Master License? *

License # *

Expiration Date * +

Additional Experiences or Training? * 🛈

List Any *

Additional Licenses or Certificates? *

List Any *

Other Studies? *

List Any *

Availability

What is your current employment status? *

Type of employment you are seeking? *

Will you work overtime if asked? *

How soon could you report to work? * +

References

Do not list relatives or former employers.

Reference 1

Name *

Occupation *

Phone *

Email Address (optional)

Reference 2

Name *

Occupation *

Phone *

Email Address (optional)

Employment History

Please enter the following information to indicate your current and prior work record. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer "see resume."

Current Employment

Select applicable *

Company Name *

Type of Business *

Address *

Phone *

Start Date * +

Position *

Salary *

Reason for Leaving *

Prior Employment

Please select the number of prior jobs? *

Employer 1

Select applicable *

Company Name *

Type of Business *

Address *

Phone *

Start Date * +

End Date * +

Position *

Salary *

Supervisor/Manager *

Reason for Leaving *

May we contact? *

Employer 2

Select applicable *

Company Name *

Type of Business *

Address *

Phone *

Start Date * +

End Date * +

Position *

Salary *

Supervisor/Manager *

Reason for Leaving *

May we contact? *

Employer 3

Select applicable *

Company Name *

Type of Business *

Address *

Phone *

Start Date +

End Date * +

Position *

Salary *

Supervisor/Manager *

Reason for Leaving *

May we contact? *

Background Report

PLEASE READ THE FOLLOWING VOLUNTARY CONSENT FOR BACKGROUND REPORT

In order to permit Design Electric, Inc. to verify information provided in connection with my employment I hereby consent to the procurement of a background report. This report may contain information regarding my previous employment, credit history, drug use, and/or criminal convictions, or any other items stipulated on my resume or employment application. I understand that any information obtained will be held in strict confidence and that I will be entitled to a copy upon written request. I also understand and agree that if the report reveals that false or misleading information was used to obtain a job, it will be grounds for dismissal. Do you accept? *

I certify that the information I have given in this application is true in all respects, and I agree that if employed and information is found to be false in any way, that I may be subject to dismissal without notice, if and when discovered. I authorize the use of any information on this application to verify my statements. I further agree, if employed, that I will work faithfully and diligently, avoid accidents, come to work promptly, and if I am absent for any reason, without prior notice to my supervisor, that my employment is terminable. Do you accept? *

Please Sign * 🛈

clear

Date * +

Resume

Would you like to submit a copy of your resume? *

Please provide any additional comments you wish to make