Position(s) Applied For *

Date of Application *

Name *

First

Middle

Last

Address *

Address Line 1

City

State

Zip Code

Telephone Number *

Best time to contact you at home is: *

If you are under 18 years of age, can you provide required proof of your eligibility to work?

Yes
No

Have you ever filed an application with us before? *

Yes
No

Have you ever been employed with us before?

Yes
No

Do any of your friends or relatives, other than spouse, work here? *

Yes
No

Are you currently employed? *

Yes
No

May we contact your present employer? *

Yes
No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? *

Yes
No

Proof of citizenship or immigration status will be required upon employment.

Date available for work: *

What is your desired salary range? *

Are you available to work: *

Full Time
Part Time
Temporary

Are you currently on "lay-off" status and subject to recall? *

Yes
No

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EDUCATION

High School

Name of High School

High School Address

Address Line 1

City

State

Zip Code

Number of Years Completed

Diploma/Degree

Yes
No

Undergraduate College

Name of Undergraduate College

Undergraduate College Address

Address Line 1

City

State

Zip Code

Course of Study

Number of Years Completed

Diploma/Degree

Yes
No

Graduate/Professional

Name of Graduate/Professional Organization

Course of Study

Number of Years Completed

Diploma/Degree

Yes
No

Other (Specify)

Name of Other Organization

Course of Study

Number of Years Completed

Diploma/Degree

Yes
No

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

ADDITIONAL INFORMATION

State any additional information you feel may be helpful to us in considering your application, including any job related training in the U.S. Military.

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB WHICH YOU ARE APPLYING. Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given.

Yes
No

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include any job-related military service assignments and volunteer activities. Exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer

Employer Address

Address Line 1

City

State

Zip Code

Employer Telephone Number

Starting/Present Job Title:

Supervisor:

Starting Date Employed

To Date Employed

Starting Hourly Rate/Salary

Final Hourly Rate/Salary

Work Performed

Reason for Leaving:

May We Contact?

Yes
No

Employer #2

Employer #2 Address

Address Line 1

City

State

Zip Code

Employer #2 Telephone Number

Starting/Present Job Title:

Supervisor:

Starting Date Employed

To Date Employed

Starting Hourly Rate/Salary

Final Hourly Rate/Salary

Work Performed

Reason for Leaving:

May We Contact?

Yes
No

Employer #3

Employer #3 Address

Address Line 1

City

State

Zip Code

Employer #3 Telephone Number

Starting/Present Job Title:

Supervisor:

Starting Date Employed

To Date Employed

Starting Hourly Rate/Salary

Final Hourly Rate/Salary

Work Performed

Reason for Leaving:

May We Contact?

Yes
No

REFERENCES

Do not include family members or past supervisors.

Reference Name

First

Last

Reference Phone Number

Best Time To Call

Occupation

Reference #2 Name

First

Last

Reference #2 Phone Number

Best Time To Call

Occupation

Reference #3 Name

First

Last

Reference #3 Phone Number

Best Time To Call

Occupation

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

APPLICANT'S STATEMENT

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Employer.

Signature of Applicant

Date

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HILL ELECTRIC APPLICATION

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EDUCATION

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

ADDITIONAL INFORMATION

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT EXPERIENCE

REFERENCES

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

APPLICANT'S STATEMENT

HILL ELECTRIC
APPLICATION