Your Personal Information

Name Phone Email Address

Education Information

High School Name and LocationGrad Y/N Major SubjectsGPA College Name and LocationGrad Y/N Major SubjectsGPA Other (spec.) Name and LocationGrad Y/N Major SubjectsGPA Special Training Activities (Civic, Athletic, Etc.)

Employment Information

State name and relationship of any relatives employed with our company Referred by Desired position Skill Level Date you can start Desired salary State of CA Electrical Certification Card # Are you currently employed? May we contact your employer? Have you ever applied to this company before? if so, when?

Reference #1

Name Phone Business/Company#Yrs. Known Address

Reference #2

Name Phone Business/Company#Yrs. Known Address

Reference #3

Name Phone Business/Company#Yrs. Known Address

Reference #4

Name Phone Business/Company#Yrs. Known Address

Employment History

Company Name Phone Date startDate end Salary Reason for Leaving

Emergency Contact

Name Phone Address

Applications for employment are only valid when application is complete and signed.
Applications are considered current and kept for a period of 14 days from application date.

Résumé information must be transferred to this application. I hereby certify that the answers given by me to the foregoing questions and statements made are true and correct, without mental reservations of any kind whatsoever. I agree to submit to a drug screen examination, if requested. I understand that my employment will be contingent upon the result of the testing. I also authorize my former employers to give any information they may have regarding me. I hereby release them and their companies from all liability for damage whatsoever for issuing same. I hereby waive any privilege I have to such information. I understand that employment is contingent upon me submitting documentary proof of identity and legal authorization to work in the United States as required.
I understand and acknowledge that if any misrepresentation or omission of facts has been made by me or if the results of an investigation are not satisfactory for any reason. Any consideration, offer or actual employment by the company may be terminated immediately without obligation of liability to me other than the rate agreed upon, for service actually rendered, if any.
I understand that employment at Ickler Electric is "at will," which means that either I or Ickler Electric can terminate the employment relationship any time, with or without prior notice and for any reason not prohibited by statute. All employment is continued on that basis, I understand that no supervisor, manager or executive of Ickler Electric, other than the president has any authority to alter the forgoing. Ickler Electric Corporation is an Equal Opportunity Employer.
I declare under penalty of perjury under the laws of the state of California that the forgoing is true and correct.