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Application for Employment - Cool Ray Electric
Personal Information
*
Indicates required field
Last Name
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First Name
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Middle Initial
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Suffix
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Address
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City, State
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Zip
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Phone Number
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Referred By
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Employment Desired
Position
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Date You Can Start
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Are you Employed?
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May We Call Employer?
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Education
High School, - GED, - Etc.
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Year
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College, Trade School
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Year
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College, Trade School
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Year
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General Information
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Special Studies,
Training that
is Relevant
to Job Desired
Military Service
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References
Name
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Phone Number
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Years
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Business
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Name
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Phone Number
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Years
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Business
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Name
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Phone Number
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Years
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Business
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Former Employers
Date From
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Date To
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Name of Business
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Address
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Phone
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Position
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Reason for Leaving
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Date From
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Date To
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Name of Business
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Address
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Phone
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Position
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Reason for Leaving
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Date From
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Date To
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Name of Business
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Address
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Phone
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Position
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Reason for Leaving
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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
to give you any and all information concerning my previous employment and any pertinent information
they may have, personal or otherwise, and release the company from all liability for any damage
that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement
for employment for any specified period of time, or to make any agreement contrary to the foregoing,
unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited
by the American with Disabilities Act (ADA) and other relevant Federal and State Laws.
Date
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E-Signature
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