Gaudette Electric, Inc., Electrical Contractor

Employment Application
Gaudette Electric, Inc.

All information will be kept in strictest confidence.
We are a drug free workplace and an equal opportunity employer.

Personal Data
Your Name: (last, first, middle)
Social Security Number:
Address:
City:
State:
Zip:
Home Phone:
Message Phone:
Email address:
If employed, can you provide proof of U.S. citizenship? Yes No N/A
Are you 18 or over? Yes No
Position(s) applying for:
Referred by:
Do you hold a current Journeyman Electricians Comp. Card? Yes No
Date exam was taken?
Testing Score?
Block & Associates Proctored Exam? Yes No
If employed, will you comply with the company's Drug Free work program and Testing? Yes No
If employed, will you be able to travel and work on projects throughout the State of Florida? Yes No
Do you hold a current Florida Drivers license? Yes No
What is your Drivers license #?
If employed, will you participate in continuing education programs sponsored by the company? Yes No
Education Record
High School:
Address:
Dates attended:
Degrees or diplomas:
College/University:
Address:
Dates attended:
Degrees or diplomas:
Trade or technical training:
Address:
Dates attended:
Degrees or diplomas:
Military Service
Branch of service:
Dates of service:
Duties/special training:
Employment History - Begin with most recent employer.
1. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?

2. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?

3. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?

4. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?

5. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?

6. Employer:
Dates of employment:
Address:
City:
State:
Zip Code:
Phone:
Beginning salary:
Ending salary:
Title/duties:
Manager's name:
Why did you leave?
Personal Data
Have you been convicted of a crime (other than traffic violations) or been imprisoned during the last seven years? A conviction will not necessarily bar you from employment. Yes No If yes, explain.
Names of friends or relatives that are employed by Gaudette Electric, Inc.
Do you have any physical or mental disability that may limit your performance in the job you are applying for? Yes No If so, what can be done to accommodate your limitation?
References List two professional references who are familiar with the quality of your work, have worked directly with you, and have known you at least two years.
1. Reference:
Work phone:
Home phone:
Address:
City:
State:
Zip Code:
Relationship:

2. Reference:
Work phone:
Home phone:
Address:
City:
State:
Zip Code:
Relationship:
Required
The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report. Typing your full name in the following space constitutes your legal signature: Today's date:

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