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Telephone Numbers

If you are under 18 years of age, can you provide required proof of your eligibility to work? YesNo
Have you ever filed an application with us before? YesNo
If yes, give date

Have you ever been employed with us before? YesNo
If yes, give date

Are you currently employed? YesNo
May we contact your present employer? YesNo
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment) YesNo
On what date are you available for work?

Are you available to work: Full TimePart TimeShift WorkTemporary
Are you currently on “lay-off” status and subject to recall? YesNo
Can you travel if a job requires it?
YesNo
Have you been convicted of a felony within the last 7 years? (Conviction does not necessarily disqualify applicant from employment)
YesNo
If yes, please explain

Starting with your present or last job, include any job-related military service assignments and/or volunteer activities. You may exclude any organizations which indicate race, color, religion, national origin, handicap or other protected status.

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Special Skills and Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.

Education

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Describe any specialized training, apprenticeship, skills and extra-curricular activities:
Describe any honors you have received:
State any additional information you feel may be helpful to us in considering your application:
Do you speak, read and/or write any foreign languages? YesNo
List Professional, trade, business or civic activities and office held. (You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, or handicap or other protected status)
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References
(Give name, address, and telephone number of (3) references who are NOT related to you and are not previous employers.)
1.
2.
3.
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Have you ever had any job-related training in the United States Military? YesNo
If YES, please describe
Are you physically or otherwise unable to perform the duties of the job for which you are applying?
YesNo
Are you willing to work at least (40) hours per week? YesNo
If NO, please explain
Are you willing to work overtime if necessary? YesNo
Would you have any problems being at work on time at 7:00 a.m. each morning, except in emergency situations?
YesNo
Do you smoke?
YesNo
If YES, would you have any problems smoking in a designated area at normal break time? YesNo
Do you have reliable transportation to get you to and from work? YesNo
Do you have any relatives or affiliations with any electrical or mechanical contractors? YesNo
Do you intend to move from the Valdosta area within the next (5) years? YesNo
Do you have a telephone? YesNo
If not, would it be a problem to get one?
List (if any) all traffic violations within the past (5) years.
Are you afraid or heights?
YesNo
Who should we notify in case of an emergency?

Would you consent to a polygraph (lie detector) test considering that the employee polygraph protection act permits polygraph testing, subject to restrictions, of certain employees of private firms who are reasonably suspected of involvement in a work place incident (theft, embezzlement, etc.) that resulted in economic loss to the employer? YesNo
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 a 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 Employer. I hereby understand and acknowledge the above statement