Full Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Mobile Phone *

Home Phone

Email *

Position Applying For *

Do you want full-time or part-time work? *

Work Availability *

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
No Preference

How many hours per week can you work? *

Can you work nights? *

What is your desired salary? *

When can you start? *

Will you give your employer a notice? *

How much notice will you give? *

How did you hear about us? *

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Newspaper
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Other

Have you ever worked for or applied with ProLectric? *

Did you graduate high school? *

High School Name *

High School Location *

Did you attend a college or trade school? *

Name of the School *

Location of the School *

Number of years attended *

Have you ever been convicted of a crime? *

Please explain number and date of convictions, nature of offense, sentenced imposed and type of rehabilitation. *

Are you willing to submit to a criminal background check? *

Do you have a valid drivers license? *

What is your drivers license number? *

What is the state of issue? *

What is the expiration date? *

Do you have reliable transportation? *

What is your means of transportation? *

Have you had any accidents in the last 3 years? *

How many accidents? *

Have you had any moving violations in the last 3 years? *

How many moving violations? *

Are you a tobacco smoker? *

Are you willing to submit to a drug and alcohol screening? *

Have you ever served in the Armed Forces? *

Date Entered *

Date Discharged *

Are you currently a member of the national guard or reserve? *

List any specialty or relevant training you've received

Reference #1

Full name *

Address *

Phone number *

Email address *

Reference #2

Full name *

Address *

Phone number *

Email address *

Are you currently employed? *

Employer Name *

Employer Address *

Employer Supervisor *

Starting Pay *

Current Pay *

Enter your job title *

Enter your job Duties *

May we contact your current employer? *

What's the best number to call? *

Do you have a previous employer? *

Previous Employer Name *

Previous Employer Address *

Previous Employer Supervisor *

Dates of employment *

Starting pay *

Ending pay *

Previous Employer Job Title *

Previous Employer Job Duties *

Previous Employer Reason For Leaving *

May we contact your previous employer? *

Previous Employer Phone *

Are you applying for an administrative position? *

Please rate yourself on a scale of 1 to 10 (1 = no experience and 10 = very skilled) based on experience and skill mastery.

Please rate yourself on a scale of 1 to 10 (1 = no experience and 10 = very skilled) based on experience and skill mastery. *

give abilities very

Please rate yourself on a scale of 1 to 10 (1 = no experience and 10 = very skilled) based on experience and skill mastery. *

Summarize your abilities and background and why you feel you would be a good fit for us. *

Signature *

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Date Signed *

Located

(912) 210-1100

8am -5pm

Located

(912) 210-1100

8am -5pm

We are always looking for new team members!

Apply Now Today!

Reference #1

Reference #2

Please rate yourself on a scale of 1 to 10 (1 = no experience and 10 = very skilled) based on experience and skill mastery.

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