Southland Electric Application for Employment

Southland Electric Application for Employment

Personal Information

Name Name * Title First Middle Last Suffix
Physical Street Address Physical Street 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 the legal right to be employed in the United States? *

Do you have the legal right to be employed in the United States? Yes No
Educational Background
Highest Level Achieved: *
Name of School/University *
Location of School/University *
Have you had any former experience as en electrician? *

Have you had any former experience as en electrician? Yes No
Highest Level Achieved (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
Diversity, Equity and Inclusion

At Southland Electric, we are committed to building and fostering diversity, equity and inclusion and removing barriers to the employment and advancement of persons from underrepresented groups. As part of this commitment, we encourage all applicants to respond to the following self-identification questions on a voluntary basis. Your responses will be kept confidential and will not be accessible by managers and/or used in the recruitment process. Applicants will not experience any adverse consequences for choosing not to participate.

We are committed to a policy of nondiscrimination in our employment and personnel practices. Applicants are considered for all employment without regard to race, color, religion, gender identity, sexual orientation, national origin, age, disability, veteran status, and any other characteristic protected by law.
Gender
Gender Identity
Ethnicity
Race
Veteran Status
Voluntary Self-Identification of Disability

Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do I know if I have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

Blindness
Deafness
Cancer
Diabetes
Epilepsy
Autism
Cerebral palsy
HIV/AIDS
Schizophrenia
Muscular dystrophy
Bipolar disorder
Major depression
Multiple sclerosis (MS)
Missing limbs or partially missing limbs
Post-traumatic stress disorder (PTSD)
Obsessive compulsive disorder (OCD)
Impairments requiring the use of a wheelchair
Intellectual disability (previously called mental retardation)
Disability
Signature
Draw your signature into the box below.

Draw or Type

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Full Name

I understand this is a legal representation of my signature.
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 event, 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 disclosure of such information by Reliance Electric or any of its agents, employees, or representatives. I consent to have this website store my submitted information so they can respond to my inquiry.
Applicant Email (if available)
Date Application Submitted Date Application Submitted / MM / DD YYYY