Employment Form

Thank you for your interest in Alexander Electric Co. We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, age, gender, religion, national origin, marital status, veteran status, political belief, disability or any other protected status that does not prohibit performance of essential job functions.

Fields Marked with * are Required.

Name:* Current Address *

Email:

Home Phone * City State Zip

Cell Phone Previous Address

Do you have the legal right to work in the United States? Have you ever been convicted of a crime?

If yes, explain:

How were you referred to this company?

Position(s) applying for: Date Available:

Salary / Wage expected: Have you applied for a job with Alexander Electric Co. before?

Have you ever been employed by Alexander Electric Co. before?

List any friends or relatives who are presently (or have been formerly) employed by this Company?

Do you have a valid driver's license? Have you had any accidents or traffic violations in the past 3 years?

Give details (AN MVR WILL BE RUN)

EDUCATION

SCHOOL	NAME AND LOCATION	NO. OF YEARS	COMPLETION DATE
Elementary
High School
College
Trade/Business School
Training/Apprenticeship

EMPLOYMENT HISTORY

List each job held starting with your most recent or current employer. Include military service assignments.

Employer Supervisor

Address Telephone No.

Date of Hire Termination Date Starting pay Last pay

Job title and duties

Reason for leaving May we contact this employer?

Employer Supervisor

Address Telephone No.

Date of Hire Termination Date Starting pay Last pay

Job title and duties

Reason for leaving May we contact this employer?

Employer Supervisor

Address Telephone No.

Date of Hire Termination Date Starting pay Last pay

Job title and duties

Reason for leaving May we contact this employer?

REFERENCES

Do not list relatives or former employers.

Name and Occupation	Address	Telephone No.

AGREEMENT AND CERTIFICATION

I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons 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 an interview is intended to create an employment contract between Alexander Electric Company and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Alexander Electric Company unless made in writing. If an employment relationship is established, I understand that I have the right to terminate any employment at any time and that Alexander Electric Company retains the same right.

I understand that prior to being offered employment with Alexander Electric Company I may be requested to take an examination. In the event I have a disability which will affect my ability to take the test, I will so inform Alexander Electric Company prior to the test so that a reasonable accommodation can be made. Requested accommodations may include accessible testing sites, modified testing conditions, and accessible testing formats. Alexander Electric Company reserves the right to require medical documentation concerning the need for accommodation. I further understand that if an offer of employment is tentatively made to me, it is conditioned upon my successful completion of a medical examination, including a drug test.

I understand that if employed, policies and rules which are issued are not conditions of employment and that Alexander Electric Company may revise policies or procedures, in whole or in part, at any time.

I understand that this application will be kept on active file for 30 days from this date, after which time I would have to reapply, in accordance with established company procedures.

Attachment: PDF. WORD DOCUMENTS

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Alexander Electric Company • 1411 Belfast Avenue • Columbus, GA 31904 • 706.327.1502 (p) • 706.596.0403 (f)