Application For Employment | Bodart Electric

Personal Information

Date

Name*

First Last

Social Security Number*

Present Address*

Street Address Address Line 2 City State ZIP Code

Is this your permanent address?*

Yes
No

Permanent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Email

How did you learn of this job?

Employment Desired

Position

Date you can start

Salary desired

Are you employed?

Yes
No

May we inquire of your present employer?

Yes
No

General Information

Do you possess a valid State of Wisconsin Driver's License?

Yes
No

Do you possess a valid Commercial Driver's License?

Yes
No

What type?

Did you graduate from high school?

Yes
No

Name and location of school:

Have you passed a high school equivalency or GED test?

Yes
No

Location & date of test:

Have you had any electrical training/schooling experience?

Yes
No

Please describe your experience:

Do you have any other special skills or schooling? (For example, welding skills, college courses)

Affirmative responses to the following three questions do not constitute an automatic bar to employment. We require conviction and arrest information to evaluate circumstances of the offense as it relates to employment with Bodart Electric Service, Inc. Please explain any "yes" answers.

Have you ever been convicted of an ordinance violation, misdemeanor, or felony?*

Are there any ordinance, felony, or misdemeanor violation charges presently pending against you?*

Have you ever had a traffic violation or are any pending against you (including speeding, seatbealt violations, etc.)*

Personal References

Name

Address & phone number

How known & how many years?

Name

Address & phone number

How known & how many years?

Name

Address & phone number

How known & how many years?

Former Employers

Name & Address of Employer

Phone Number

From

To

Title of position held

Starting Salary

Ending Salary

Supervisor's Name & Title

Reason for leaving

Duties of your position

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above are authorized to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and I release Bodart Electrical Service, Inc. from all liability for any damage that may result from utilization of such information. If employed by Bodart Electric Service, Inc. I understand that my employment depends upon my successful performance during a 60 day probationary period. Bodart Electric Service, Inc is an at-will employer and employment depends upon business requirements and satisfactory individual performance. Bodart Electric Service, Inc. is a drug-free and violence-free workplace. I consent freely and voluntarily to participate in required drug tests.

Applicant's Signature*

Date