SORREL ELECTRICAL SPECIALTIES, LLC
Employment Application
 
APPLICANT INFORMATION
Last Name
 
First
 
M.I.
 
Date
 
Street Address
 
Apartment/Unit #
 
City
 
State
 
Zip
 
Phone
 
Date of Birth
 
Date Available
 
Social Security No.
 
Desired Salary
 
Position Applied for
 
Are You 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 so, when?
 
Have you ever been convicted of a felony?
Yes No
If yes, explain
 
EDUCATION
High School
 
Address
 
From
 
To
 
Did you graduate?
Yes No
Degree
 
College
 
Address
 
From
 
To
 
Did you graduate?
Yes No
Degree
 
Other
 
Address
 
From
 
To
 
Did you graduate?
Yes No
Degree
 
REFERENCES
Please list three professional references.
 
Full Name
 
Relationship
 
Company
 
Phone
 
Address
 
Full Name
 
Relationship
 
Company
 
Phone
 
Address
 
Full Name
 
Relationship
 
Company
 
Phone
 
Address
 
PREVIOUS EMPLOYMENT
Company
 
Phone
 
Address
 
Supervisor
 
Job Title
 
Starting Salary $
 
Ending Salary $
 
Responsibilities
 
From
 
To
 
Reason for Leaving
 
May we contact your privious supervisor for a reference?
Yes No
 
Company
 
Phone
 
Address
 
Supervisor
 
Job Title
 
Starting Salary $
 
Ending Salary $
 
Responsibilities
 
From
 
To
 
Reason for Leaving
 
May we contact your privious supervisor for a reference?
Yes No
 
Company
 
Phone
 
Address
 
Supervisor
 
Job Title
 
Starting Salary $
 
Ending Salary $
 
Responsibilities
 
From
 
To
 
Reason for Leaving
 
May we contact your privious supervisor for a reference?
Yes No
 
MILITARY SERVICE
Branch
 
From
 
To
 
Rank at Discharge
 
Type of Discharge
 
If other than honorable, explain
 
 
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
 
Date