Application for Employment

Date

Full Name

Street Address Phone Number

City State Zip Code

Date of Birth Height Weight

Postiion Applied For: SS# Desired Salary

Email Address

Do you have a driver's license? Yes No

Driver's License #

Do you have any friends or relatives in our employ? If so, who? Yes No

Name

Name

Are you a citizen of the United State? Yes No , If no, are you authorized to work in the U.S? Yes No

Have you ever been convicted of a felony? Yes No , If yes, explain :

Have you ever had a problem with drugs or alcohol? Yes No If yes, please explain:

Education	Name and Location of School	# of Years Attended	Did you Graduate	Course of Study	Date Left
Grammer School			Y N
High School/GED			Y N
College/University			Y N
Apprentiship School			Y N

Have you ever served in the Armed Forces of the U.S? Yes No
Rank and Branch of service Discharge Date

Do you have any mental or physical disablities that may affect your ability to perform the worked required
for someone in the position you are applying for? Yes No
If so, please explain

Employment History

Employers Name & Address	Kind of Work	Wages	Date Started	Date Left	Reason

In case of accident, notify Phone

Address City State

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understant that false or misleading information in my application or interview may result in my release.

Under Maryland Law an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector, or similiar test or examination as a condition of employment or continued employment. Any employer who violates this provision is guilt of a misdemeanor and subject to a fine not to exceed $100.00.

I understand Yes No

If you are applying for an electricans position or have some electrical experience please click the link below and complete the test and either email, mail, or drop of to our office.

Employment Test