Reliance Electric Application for Employment

Personal Information
Applicant Name Applicant Name * Title First Middle Last Suffix
Physical Address Physical Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Mailing Address Mailing Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number Phone Number * - ### - ### ####
How did you hear about this job opening?
Position Applied For
Date you can start Date you can start / MM / DD YYYY
Wage Desired
Special Training or Skills
Would you accept full time work?

Would you accept full time work? Yes No
Would you accept part-time work?

Would you accept part-time work? Yes No
Do you have legal right to be employed in the United States? *

Do you have legal right to be employed in the United States? Yes No

If yes, you must upload proof of citizenship.
Educational Background
Highest Level Achieved *
Name of School/University *
Location of School/University *
Have you had any former experience as an electrician? *

Have you had any former experience as an electrician? Yes No
Highest Level Achieve (if yes)
Upload Resume

Attach Files
Work History

Most Recent Former Employment (if applicable)
Name of Employer
Phone of Employer Phone of Employer - ### - ### ####
Position
Beginning Date Beginning Date / MM / DD YYYY
Ending Date Ending Date / MM / DD YYYY
Reason for Leaving
Name of Employer
Phone of Employer Phone of Employer - ### - ### ####
Position
Beginning Date Beginning Date / MM / DD YYYY
Ending Date Ending Date / MM / DD YYYY
Reason for Leaving
Name of Employer
Phone of Employer Phone of Employer - ### - ### ####
Position
Beginning Date Beginning Date / MM / DD YYYY
Ending Date Ending Date / MM / DD YYYY
Reason for Leaving
References
1. Reference Name 1. Reference Name * First Last
Phone Phone * - ### - ### ####
2. Reference Name 2. Reference Name * First Last
Phone Phone * - ### - ### ####
3. Reference Name 3. Reference Name * First Last
Phone Phone * - ### - ### ####
Emergencey Contact
Emergency Contact Name Emergency Contact Name * First Last
Phone Phone * - ### - ### ####
Signature
Draw your signature into the box below. *

Draw or Type

I declare under penalty of perjury that I personally completed this application and that, to the best of my knowledge, the information contained in this application is true and complete. I understand that any false information or significant omissions may disqualify me from further consideration of employment and, in the even I become employed, may result in the termination of my employment if discovered at a later date.
I understand and agree that nothing contained in this application is intended to create an employment contract between me and the company. I also understand and agree that if I am hired, my employment with the company will be at will, and may be terminated by either me or the company at any time, with or without cause of advance notice. I understand that no promises or representations to the contrary will be binding on the company unless made in writing signed by both me and the Chief Executive Officer of the company.
I authorize the references listed above, as well as the other individuals whom Reliance Electric contacts, to provide Reliance Electric with any and all information concerning my previous employment and any other pertinent information. Further, I release all parties and persons from all liability from any damages that may result from furnishing such information to Reliance Electric as well as any use or discolsure of such information by Reliance Electric or any of its agents, employees, or representatives. Clear

Full Name

I declare under penalty of perjury that I personally completed this application and that, to the best of my knowledge, the information contained in this application is true and complete. I understand that any false information or significant omissions may disqualify me from further consideration of employment and, in the even I become employed, may result in the termination of my employment if discovered at a later date.
I understand and agree that nothing contained in this application is intended to create an employment contract between me and the company. I also understand and agree that if I am hired, my employment with the company will be at will, and may be terminated by either me or the company at any time, with or without cause of advance notice. I understand that no promises or representations to the contrary will be binding on the company unless made in writing signed by both me and the Chief Executive Officer of the company.
I authorize the references listed above, as well as the other individuals whom Reliance Electric contacts, to provide Reliance Electric with any and all information concerning my previous employment and any other pertinent information. Further, I release all parties and persons from all liability from any damages that may result from furnishing such information to Reliance Electric as well as any use or discolsure of such information by Reliance Electric or any of its agents, employees, or representatives.
Applicant Email (if available)
Date Date / MM / DD YYYY

Reliance Electric Application for Employment

Reliance Electric Application for Employment

Personal Information

Educational Background

Work History

References

Emergencey Contact

Signature