Your Name (required)

Your Email (required)

Today's Date

Address

City

State

Zip

Phone

Position Applying For

Date Available

Are you a US Citizen
Yes No 

If no, are you authorized to work in the US?
Yes No 

Have you worked for RS Electric before?
Yes No 

If yes, start date

End date

Have you been convicted of a felony?
Yes No 

If yes, explain

High School

High School Address

Dates Attended

Did you graduate
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College

College Address

Dates Attended

Degree

Other Education

Your most recent employer (required)

Phone

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Supervisor's Name

Your Job Title

Your responsibilities

Dates to and from

Reason for leaving

May we contact the supervisor?
Yes No 

Are you current / former military
Yes No 

If yes, what branch?

Date from

Date to

Rank at discharge

Type of discharge

If other than honorable, explain

Any other information you would like to share

How did you hear about us

Electrician Journeyman License number (required)

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. (required)
Yes