APPLICATION FOR EMPLOYMENT - Avis Electric



APPLICATION FOR EMPLOYMENT (this application will be kept on file for 30 days)

Position applied for: ( Electrician ( Apprentice Type of employment desired: ( Full Time ( Part Time

( Summer Only

|Full Name: | |Phone#: | |

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|Street Address: | |Cell or Pager#: | |

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|City, State and Zip: | | | |

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|Social Security #: | |Drivers License #: | |

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Has your driver’s license ever been revoked or suspended? ( Yes ( No If yes, explain: __________________________ _____________________________________________________________________________________________________________________

Have you ever pled “guilty” or “no contest” to or been convicted of a crime? ( Yes ( No If yes, explain: __________________________

_____________________________________________________________________________________________________________________ High School: ______________________________________________________ Years Completed: __________ Year Graduated: __________ Vocational or Trade School: __________________________________________ Years Completed: __________ Year Graduated: __________ College Degree: ___________________________________________________ Years Completed: __________ Year Graduated: __________ Hourly wage requested: ____________________________________________ If employed, date you can start work: __________________ Are you a Virginia Licensed Journeyman? ( Yes ( No Years of Experience: ________________________ Do you have any Fire Alarm Installation Experience? ( Yes ( No Years of Experience: ________________________ List three personal references that are not relatives that have known you for three years:

|Name: | |Phone#: | |

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|Name: | |Phone#: | |

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|Name: | |Phone#: | |

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Previous Employment (begin with most recent position):

Dates of Employment: ____________________ to ____________________ Position held: ____________________________________ Company: ______________________________________________ Phone: __________________ May we contact them? ( Yes ( No Reason for leaving job: _____________________________________________________________ Ending Salary: __________________ Job Description: ________________________________________________________________________________________

Dates of Employment: ____________________ to ____________________ Position held: ____________________________________ Company: ______________________________________________ Phone: __________________ May we contact them? ( Yes ( No Reason for leaving job: _____________________________________________________________ Ending Salary: __________________ Job Description: ________________________________________________________________________________________

First Aid, CPR & OSHA Training Requirement

I agree that if hired, I will complete an OSHA Compliant 10 hour safety course, and a First Aid/CPR course within 60 days of starting work. I can take this course anywhere it is offered, or I can attend the course offered free of charge through Avis Electric. I understand that I will not be paid for my time spent completing the course. I further understand that if I do not complete the course as agreed, I will not be allowed to work until I meet this requirement.

I certify that the information given here is true and accurate. I authorize Avis Electric Company, Inc. to make such investigations and inquiries of my personal, employment, educational, financial, driving or medical history and other related matters as may be necessary for an employment decision.

I hereby release employers, schools or persons from all liability in responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

Signature of Applicant: ______________________________________________________ Date:_________________

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