EMPLOYMENT APPLICATION

Employment Applicant Information

Full Name:
Last
First
Middle
Address:
Street Address
Apartment/Unit #

City
State
ZIP Code
Phone: Alt Number
Email:
Position Applied For:
Date Available:
How did you hear about us:

Are you a citizen of the United States?         If no, are you authorized to work in the U.S.?
Have you ever worked for this company?         If yes, when?    
Have you ever been convicted of a felony?         If yes, explain:    
Are you at least 18 years of age?
Has your license ever been revoked or suspended?              If yes, when?    
Explain:    
Do you have reliable transportation?
Are you available to work weekends?
Are you available for overnight travel?
Are you able to relocate?
Are you able to lift/push/pull 75+ pounds?
Are you able to stand/sit/bend on uneven
surfaces in awkward positions for 6 hours?


Education

High School: Address    
From To Did you graduate?
Degree:
 
College: Address    
From To Did you graduate?
Degree:


Professional License or Equipment

Professional Licenses or Certifications:
Issuing State: License Number:
What machinery are you highly skilled at operating?
When did you last operate this machinery?


References

Please list two professional references with whom you have worked in the past 7 years.
Full Name: Relationship:
Company: Phone:
Address:
Full Name: Relationship:
Company: Phone:
Address:


Previous Employment

Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: Ending Salary:
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?
Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: Ending Salary:
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?
Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: Ending Salary:
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?


The following information is requested for government reporting purposes only. The information you supply will not be used in our selection decision and your submission of this information is optional.

Equal Employment Opportunity Questions

Gender
 
Race/Ethnicity         





 
Veteran's Status




Date of Discharge:
 
    Definitions:
  • Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
  • White (not Hispanic or Latino) – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
  • Black (not Hispanic or Latino) – A person having origins in any of the black racial groups of Africa.
  • Native Hawaiian or Other Pacific Islander (not Hispanic or Latino) – A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  • Asian (not Hispanic or Latino) – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, incuding for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  • American Indian or Alaska Native (not Hispanic or Latino) – A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
  • Two or More Races (not Hispanic or Latino) – All persons who identify with more than one of the above races.
  • Armed Forces Service Medal – any veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
  • Recently Separated Veteran – any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.
  • Other Protected Veteran - a veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign for which a campaign badge has been authorized, under the laws administered by the Department of Defense.
  • Disabled Veteran – a veteran of the U.S. military, ground, naval or air service who is entitled to compensation under laws administered by the Secretary of Veteran Affairs, or a person who was discharged or released from active duty because of a service related disability.
 

Notice

Watts Electric is an equal opportunity employer and does not discriminate against any applicant or employee because of race, color, religion, gender, national origin, age, disability, veteran status, citizenship or any other characteristic protected by federal, state or local law.

Incomplete or illegible applications will not be processed. Please note "Not Applicable" is not answering a question. Provide only requested information, failure to do so may result in disqualification of your application.
 

Disclaimer and Signature

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 that 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 application form is valid for 90 days.


Signature: