A&W Electric Job Application
Please complete this form to start your application process.  

Please have a picture of your valid driver's license, social security number,  and your resume to send at the end of this application.  An email address will be provided at the end of this application for your driver's license and resume.  

  All information is kept secure as we use it to run our standard back ground checks for employment.  
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Email *
How did you hear about our company? *
Applicant Information
Last Name *
First Name *
Middle Name *
Street Address *
City *
State *
Zip Code *
Phone *
Social Security Number - this is used for federal background check.  All of our positions require a federal background check, driving record check, and drug test.  All information is kept secure.  

If you would like us to call you for this information, please type call.  
 *
Position(s) Applied For *
Desired Salary *
Date Available to Begin Work *
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Are you a citizen of the United States? *
If yes to above, skip to next question.  

If no to question above, are you authorized to work in the United States?
Clear selection
Have you ever worked for this company?  Yes or No - if yes, please list when.   *
Have you ever been convicted of a felony?  Yes or No - if yes, please explain.   *
Please list an emergency contact name and phone number.   *
Education
Name of High School Attended *
Address of High School Attended *
High School Attendance Dates *
Did you graduate from High School?  *
Name of College Attended
Address of College Attended
College Attendance Dates
Did you receive a degree from this college? Yes or No  If yes, please list degree(s).  
Name of College or Other School Attended
Address of College / Other School Attended
College / Other School Attendance Dates
Did you receive a degree from this college / other school? Yes or No  If yes, please list degree(s).  
References
Reference #1 - Please list full name, phone number, email address, relationship and / or company for reference.   *
Reference #2 - Please list full name, phone number, email address, relationship and / or company for reference.   *
Reference #3 - Please list full name, phone number, email address, relationship and / or company for reference.   *
Previous Employment
Previous Company Name #1 *
Company Address *
Company Phone *
Supervisor's Name *
Job Title *
Starting Salary *
Ending Salary *
Responsibilities *
Dates of Employment *
Reason for Leaving *
May we contact your previous supervisor for a reference?  *
Previous Company Name #2 *
Company Address *
Company Phone *
Supervisor's Name *
Job Title *
Starting Salary *
Ending Salary *
Responsibilities *
Dates of Employment *
Reason for Leaving *
May we contact your previous supervisor for a reference?  *
Previous Company Name #3
Company Address
Company Phone
Supervisor's Name
Job Title
Starting Salary
Ending Salary
Responsibilities
Dates of Employment
Reason for Leaving
May we contact your previous supervisor for a reference? 
Clear selection
Military Service
Branch of Military
Dates of Military Service
Rank at Discharge
Type of Discharge - If other than honorable, please explain.  
Disclaimer & Signature
By typing my full name below, I certify that my answers are true and complete to the best of my knowledge.  

My signature below confirms I understand and give A&W Electric, Inc. and its agents permission to review my driving record and conduct a background check.  Information contained in those documents may be used as part of the decision making process regarding my qualifications for this position and the hiring decision.  
 *
A copy of your responses will be emailed to the address you provided.
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