Employment Application Step 1 of 5 20% Employment ApplicationPlease note that any field marked with an asterisk (*) is required for submitting application.Submit this application to:* L-A Electric Date MM slash DD slash YYYY Position Sought: How did you learn about the position? Upload your resume or cover letter here. (.pdf or .docx files) Drop files here or Select files Accepted file types: pdf, docx, Max. file size: 30 MB, Max. files: 5. Your InformationFull Name* Street Address* Address Line 2 City* State / Province / Region* ZIP / Postal Code Country* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Phone*Secondary PhoneEmail* Are you over 18 years of age?* Yes No What date would you be available to start work? MM slash DD slash YYYY Desired Wage/Salary $ Have you ever been convicted of a felony?* Yes No If yes, please describe circumstances:Have you ever been involuntarily terminated or asked to resign from any position of employment?* Yes No If yes, please describe circumstances:If selected for employment, are you willing to a pre-employment drug screening test?* Yes No Do you have reliable transportation to work?* Yes No Are you willing to work overtime?* Yes No EducationSchool Name Years Attended Location (City, State) Degree Received Major Other training, certifications, or licenses held: List any other pertinent education information to the position you are seeking: Add Another School? Education 2School Name Years Attended Location Degree Received Major Add Another School? Education 3School Name Years Attended Location Degree Received Major References: Please list (3)Reference 1Name Business PhoneYears known Reference 2Name Business PhoneYears known Reference 3Name Business PhoneYears known Employer 1Employer Name Job Title Dates Employed Prior position held within company (if any) Location Supervisor PhoneStarting Salary Ending Salary Reasons for leaving Duties Performed Add An Employer? Employer 2Employer Name Job Title Dates Employed Prior position held within company (if any) Location Supervisor PhoneStarting Salary Ending Salary Reasons for leaving Duties Performed Add An Employer? Employer 3Employer Name Job Title Dates Employed Prior position held within company (if any) Location Supervisor PhoneStarting Salary Ending Salary Reasons for leaving Duties Performed Acknowledgment and AuthorizationBy clicking submit, I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization L-A Electric is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of L-A Electric.CAPTCHA
