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We hire applicants based solely upon the hiring needs of the Company and the applicant’s merit. We do not discriminate on the basis of race, color, national origin, gender, age, disability, religion, union affiliation, or any other legally protected status. Applicants who falsify or omit information on this application will be disqualified from being hired or subject to termination if hired. Incomplete applications will not be considered. If you receive an offer, a pre-employment drug screen will be required. Those applicants requiring accommodation to complete this application or interview process should notify a representative of the CE Human Resources Department.

Applicant Information
Name: Telephone Number
Street Address Cell Number
City State Zip Code Wage / Salary Desired
Available Start Date Years of Experience Supervisory Experience? Yes No
Position Applied for

Have you ever filed an application with us before? Yes No, If yes, when?

Have you ever been employed with us before? Yes No, If yes, when?

Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you at least 18 years of age? Yes No
Have you served an Apprenticeship? Yes No
How Long? Where?

Have you passed a Journeyman or Master Electrician Exam? When/Where?

Availability: Full Time Part Time Temporary
Are you willing to travel Yes No
Do you have any felony convictions Yes No
Are you presently authorized to work in the US? Yes No
(Proof of US citizenship or legal authorization to work required upon employment)
 
Educational Background:
High School Diploma/GED: Year/School:
City/State
College Degree: Year/School:
City/State
Other Certifications/Licenses:
City/State
 
Describe any job-related training received in the U.S. Military (if none, state none):
 
Describe any specialized electrical related training, apprenticeship, or job related skills (if none, state none):
 
Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you believe will be helpful to us in considering your application (if none, state none):
 
Work Experience: Start with most recent or present employer. Complete in full even if resume is attached
Employer Name Date Employed
Address Job Title
Phone Ending Salary
Supervisor Eligible For Rehire Yes No
Reason For Leaving:
 
Employer Name Date Employed
Address Job Title
Phone Ending Salary
Supervisor Eligible For Rehire Yes No
Reason For Leaving:
 
Employer Name Date Employed
Address Job Title
Phone Ending Salary
Supervisor Eligible For Rehire Yes No
Reason For Leaving:
 
Employer Name Date Employed
Address Job Title
Phone Ending Salary
Supervisor Eligible For Rehire Yes No
Reason For Leaving:
 
Employer Name Date Employed
Address Job Title
Phone Ending Salary
Supervisor Eligible For Rehire Yes No
Reason For Leaving:
 
References: Do not list relatives or former employers.
Name City/State Contact Number Years Known Relationship to Applicant
 
Disclaimer and Signature

I certify that the information given by me in this application is true. I understand that if the information is found to be false in any way, Corbins Electric may refuse to employ me or discharge me if I have begun working when it is discovered. I authorize the use of any information in this application to verify my statements, and I authorize my past employers and any other references or persons I have listed to answer all questions asked concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account of having furnished such information.

I understand that nothing contained in this employment application or in the granting of any interview is intended to create an employment contract or reasonable expectations of employment with Corbins Electric. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Corbins Electric unless made in writing by an authorized officer of the Company. If an employment relationship is established, I understand that I will be an “at-will” employee and either Corbins Electric or I will have the right to terminate my employment at any time, with or without cause.

I understand that if employment is offered, my employment may be conditioned upon the results of a medical examination to ensure my ability to perform the essential functions of the job and that as a condition of employment I will be required to take drug and alcohol screening tests and such medical examinations as may be required by Corbins Electric, including physical examination. I agree to submit to these required tests and understand that becoming employed and/or my continued employment are conditional upon the successful passing of these tests in accordance with Company policies and procedures, given reasonable accommodations in accordance with the Americans with Disabilities Act.

If employed, I understand and agree to abide by all Corbins Electric policies, procedures, guidelines and training (including, but not limited to, the current Safety Policy) and that my continued employment with Corbins Electric is conditioned upon my compliance with, and satisfactory performance of, these requirements. I also understand that Corbins Electric may revise these policies, procedures, guidelines and training at any time with or without notice.

I also understand that this application will be kept on active file for thirty (30) days from the date completed, after which time I would have to re-apply in accordance with established Company procedures.

 
Name/Signature:
Date:
Corbins Electric is an equal opportunity employer

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