Employment Application

We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Your Personal Information

Please fill out all information below completely and accurately. All information is required in order to process your application. No action can be taken on this application unless all questions are answered and complete. You may upload a copy of a resume at the end of this application to be attached with the application. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job related information.

Position You're Applying For*

Construction Apprentice
Construction Electrician
Material Handler
Office Staff

Today's Date:*

Are you seeking:*

Full-Time
Part-Time
Temporary

Last Name*

First Name*

Middle Name*

Your Current Phone Number to be reached at*

Your Current Home Address*

Street Address Unit / Suite Number City State Zip Code

Your Email Address*

Where did you hear about this career opening?*

i.e. Craigslist, Newspaper, Facebook

Employment Information

Date You Can Start*

Have you ever applied for a job at Adams Electric, Inc. before?*

Yes
No

If so, when?

Have you ever been employed at Adams Electric, Inc. before?*

Yes
No

If so, when was separation?

Desired Hourly Salary

Are you legally authorized to work in the US?*

Yes
No

General Information

Do you posses a current valid drivers license?*

Yes
No

Drivers License #*

State drivers license issue in*

Drivers License Class*

R, CDL, B, etc.

Have you had your driver's license suspended or revoked in the last 3 years?*

Yes
No

If yes to above, please explain

Will you allow this company to run a background check on you? If yes, by acknowledging the terms below and submitting this application, you give permission for Adams Electric, Inc to run a background check on you.*

Yes
No

Education & Work History

Do you have Military Service?*

Yes
No

Military Service History*

List all that apply

Branch	Start Date	End Date	Rank

Discharge Status?*

Do you have electrical construction experience?*

Yes
No

If so, for how long?

(4-months, 6-years)

Do you carry a journeyman license for CO?*

Yes
No

If yes,

#	Exp

Electrical Residential Experience:*

Check all that apply.

Electrical Commercial Experience:*

Check all that apply.

Electrical Industrial Experience:*

Check all that apply.

Electrical HVAC Controls Experience:*

Check all that apply.

N/A - Not Applicable
Commercial Applications
Industrial Applications
EMT Conduit
GRC Conduit
Cable Pulling/Install
Cable Terminations
Programming and Testing
Maintenance & Troubleshooting

Electrical Supervision Experience:*

Check all that apply.

Do you have other experience?*

Check all that apply.

Other Experience? Explain

High School Attended*

Place N/A in all fields if this does not apply. You may add additional lines by clicking the "+" sign to the right of the last line.

School Name	Year Completed	Did you Graduate?	Degree/Diploma

College Attended*

Place N/A in all fields if this does not apply. You may add additional lines by clicking the "+" sign to the right of the last line.

School Name	Year Completed	Did you Graduate?	Degree/Diploma

Trade School Attended*

Place N/A in all fields if this does not apply. You may add additional lines by clicking the "+" sign to the right of the last line.

School Name	Year Completed	Did you Graduate?	Degree/Diploma

Special Training

(OSHA, Fork Lift, Welding, Etc.) You may add additional lines by clicking the "+" sign to the right of the last line.

Training	Date	Trainer

Certificates

List all that apply. You may add additional lines by clicking the "+" sign to the right of the last line.

Name	Date Received

Special Skills

List all that apply. You may add additional lines by clicking the "+" sign to the right of the last line.

Your Previous Employment*

List names of at least your previous three employers in consecutive order. Account for all periods of time including military service and periods of unemployment. You may add additional lines by clicking the "+" sign to the right of the last line.

Employer Name	Start Date (mo/yr)	End Date (mo/yr)	Position held	Supervisor	Supervisor Phone	Pay Start	Pay End	Reason for leaving

May we contact the employers listed above?*

Yes
No

Have you ever been fired from a job or asked to resign?*

Yes
No

If yes, please explain:

List additional comments that relate to the job for which you are applying:

Type N/A if no additional comments.

References:*

List at least three references. (Cannot be relatives or former employers). You may add additional lines by clicking the "+" sign to the right of the last line.

Name	Trade or profession	Phone Number	Association to Applicant

Resume and other document upload (Up to 4 Doc's)

Upload other documents in .pdf, .doc or .docx format

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 256 MB, Max. files: 4.

The Legal Stuff

Terms and Conditions (please read each statement carefully before submitting)

By agreeing to our terms, I certify that all of the information contained in this application is true and complete. I understand that any misrepresentations, omission or false information that I provide, either in this employment application or at any other time during the application and hiring process, may result in the disqualification of my application for employment or, if I am hired, in the immediate termination of employment at any point in the future.

I understand and agree that this employment application, verbal statements by management, or subsequent employment does not guarantee employment on any terms or create an express or implied contract nor does it guarantee employment for any definite period of time. I further understand and agree that, if I am hired, it will be on a strictly at-will basis, meaning that just as I am free to resign at any time, Adams Electric, Inc. has the right to terminate my employment at any time, with or without reason and with or without prior notice. No implied oral or written agreements contrary to this at-will employment basis are valid unless they are in writing and signed by a corporate representative of Adams Electric, Inc.

I understand that Adams Electric, Inc. may seek to verify any or all information listed above or otherwise provided by me during the application and hiring process. I hereby expressly authorize Adams Electric, Inc. to verify that information, without further notice to or consent by me, and I authorize prior employers and others from whom such verification is sought to release relevant information about me. I further authorize Adams Electric, Inc. to investigate all references and secure additional information about me.

I hereby release from liability Adams Electric, Inc. and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

Adams Electric, Inc. is an Equal Opportunity Employer. Adams Electric, Inc. does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state or federal law.

I understand that I may be required to successfully pass a background screening. I also understand that I may be required to pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required.

Applicant Affirmative Action Information

This information is being gathered for affirmative action under Section 503 of the Rehabilitation Act of 1973. It is the policy of this organization to provide equal employment opportunity to all qualified applicants for employment without regard to race, color, religion, national origin, sex, age, veteran status or disability.

Completion of this portion of the application is voluntary and will be kept confidential. This information is not part of the employment application and will not be considered in the employment/selection process. An applicant will not be subject to any adverse treatment for refusing to complete this portion/questionnaire. If you choose to provide the information, please complete the following:

Affirmative Action Information:

Last Name	First Name	Middle Name	Date

Racial origin (You may select one or more of the following):

White-(Not Hispanic or Latino)origins in Europe, the Middle East, or North Africa
American Indian or Alaska Native-(Not Hispanic or Latino)origins in North or South America
Black or African American-(Not Hispanic or Latino)origins in any of the black racial groups of Africa
Asian-(Not Hispanic or Latino)origins in the Far East, Southeast Asia, or the Indian Subcontinent, including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, The Philippine Islands, Thailand, and Vietnam.

Ethnicity:

Hispanic or Latino-Cuban, Mexican, Puerto Rican, South or Central America

Gender:

Male
Female
I elect not to identify

Acceptance*

I have read, understand, and by submitting this application consent to these statements.

I agree to the Terms and Conditions

Comments

This field is for validation purposes and should be left unchanged.