Southland Electric General Application for Employment

Name Name * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
Position Applying For *
Date available to start Date available to start * / MM / DD YYYY
Desired Wage *
Referral Source *

Referral Source Online Ad Rehire Walk-In Employee (Add Name in box) Employee (Add Name in box)
Do you have a resume? *

Do you have a resume? Yes No