Position(s) Applying for:

PERSONAL INFORMATION

Email

How did you hear about our company?

EMPLOYMENT INFORMATION

Current Employer (if any):

Years of Work Experience directly related to the position you are applying for:

Desired Compensation:

$

Other Compensation Desired:

When are you available to start work?

EDUCATION

Please include the type of school (i.e. high school, college, trade school), name of school, location, number of years completed, and major or degree

CRIMINAL HISTORY

If yes, please explain and attach any relevant documentation.

DRIVER'S LICENSE INFORMATION

Do you have reliable transportation to work (please be specific)?

Driver’s license number:

Include state of issue

List any Moving Violations and/or Accidents from the last 3 years:

MILITARY SERVICE

Military Branch:

Specialty, Date Entered, Discharge Date, and Type of Discharge

WORK EXPERIENCE

Please list your work experience for the past 5 years, beginning with your most recent job. If you were self-employed, give firm name. Attach additional sheets if necessary. Attach resume if applicable.

Employer #2

Employer #3

Employer #4

ELECTRICAL INDUSTRY SKILLS

ONLY select the specific industry skills that you consider yourself to be very knowledgeable about, with a high level of competency.

CERTIFICATIONS & LICENSES

Include State and License Numbers for any licenses selected above, if applicable:

Other Licenses & Certifications held:

ADDITIONAL INFORMATION

Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying. If you have a resume, please include it with this application.

PROFESSIONAL REFERENCES

Please list 3-4 people you have worked with who can attest to your on-the-job experience and performance.

Professional Reference #2

Professional Reference #3

Professional Reference #4

If not, who did?

AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)

I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with MSC Electrical creates an actual or implied contract of employment. I understand that if I accept employment with MSC Electrical, it will be on an at-will basis. This means that either MSC ELECTRICAL or I have the right to terminate the employment relationship at any time, for any Reason, with or without cause. I agree to submit to drug and alcohol testing if requested by MSC Electrical. I release MSC Electrical and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. I authorize MSC ELECTRICAL to investigate information concerning my education, licensing, certifications, driving record, criminal history, employment experiences, and all other aspects of my background relevant to my proposed employment. I release MSC Electrical and its employees from all liability arising from such investigation.