Name:

Position of Interest:

Email Address:

Telephone:

Have you ever filled out an application with us before? YES NO

If YES, when?

Have you ever been employed with us before? YES NO

If YES, when?

Are you currently employed? YES NO

May we contact your current employer?
YES NO

If you are under 18 years of age, can you provide proof of your eligibility to work? YES NO

Are you prevented from becoming employed in the United States of America due to Visa or Immigration Status? YES NO

Have you been convicted of a felony in the past 7 years? YES NO

If YES, explain:

Did you ever serve as an apprentice? YES NO

If YES, how long?

Where?

Have you ever passed a Journeyman or Master Electrician examination? YES NO

If YES, where?

How many years experience have you had in the electrical industry?

In the position you are applying for?

On what date would you be available to begin work?

Are you available to work: FULL TIME PART TIME TEMPORARY SHIFT WORK

EDUCATION: Tell us about your education.

High School:

City/State:

Years:

Diploma:

College (Undergraduate):

City/State:

Years:

Diploma:

College (Graduate):

City/State:

Years:

Diploma:

Other (Specify):

City/State:

Years:

Diploma:

EXPERIENCE: Start with your most recent, or present job & work backward; listing your last 3 jobs.

JOB 1: Employer:

Telephone:

Address:

Supervisor:

Fax Number:

Job Title:

Salary:

Dates Employed: From: To:

Work Performed:

Reasons for Leaving:

JOB 2: Employer:

Telephone:

Address:

Supervisor:

Fax Number:

Job Title:

Salary:

Dates Employed: From: To:

Work Performed:

Reasons for Leaving:

JOB 3: Employer:

Telephone:

Address:

Supervisor:

Fax Number:

Job Title:

Salary:

Dates Employed: From: To:

Work Performed:

Reasons for Leaving:

Summarize special job-related skills and qualifications aquired from employment or other experience:

Thank you! Meis Electric will contact you if there is a position available.