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Application For Employment

Prime Electric Company, Inc
300 Vista Lane. Edmond, OK 73034
405.359.9190

This application is valid for 15 days only from date signed.

*All fields are required

General Employment Application

Personal Information

Date of Application *

Name (First, MI, Last) *

Address *

City *

State / Zip *

Phone Number *

Height *

Weight *

Email Address *

Date of Birth *

Marital Status *

Single

Married

Legally Separated

Do You Have Children? If yes, how many? If No, write N/A *

Referred By? *

How Did You Hear About Us? *

End Section

Emergency Contact

Emergency Contact Name (First and Last) *

Emergency Contact Phone Number *

Emergency Contact Address *

Emergency Contact Relationship

End Section

Employment

Employment Desired (check one) *

Journeyman

Apprentice

Office

Construction Manager

Sales

Desired Starting Date *

Ever applied to this Company before? *

Yes

No

Are you employed now? *

Yes

No

May we inquire of your employer? *

Yes

No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment) *

Yes

No

Are you currently on "lay-off status" and subject to recall? *

Yes

No

Can you travel if a job requires it? *

Yes

No

Can you currently pass a drug test? *

Yes

No

Do you currently have a Medical Marijuana license? *

Yes

No

Have you been convicted of a felony within the last 7 years? *

Yes

No

If You Answered Yes To Conviction of a Felony, Please Explain. *

If you answered no, please Type N/A If Not Applicable

Do you have any physical limitations that exclude you from performing any work for which you are being considered? *

Yes

No

If You Answered Yes To Physical Limitations, Please Explain. *

If you answered no, please Type N/A If Not Applicable

Government agencies require periodic reports on the sex, ethnicity, handicap and veteran status of applicants. This area is for analysis and affirmative action only. Submission of information about a handicap is voluntary. *

Male

Female

Ethnicity *

White

African American

Hispanic

American Indian / Alaskan Native

Veteran Status *

Vietnam Era Vet

Disabled Vet

Handicapped

Non-Veteran

End Section

Former Employers

Current or Previous Employer Starting Date *

If Currently Unemployed, Type Unemployed

Current or Previous Employer End Date

If Currently Unemployed, Type Unemployed

Current or Previous Employer Name *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Address *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Phone *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Supervisor *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Position *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Salary *

If Currently Unemployed, Type Unemployed

Current or Previous Employer Reason/s For Leaving *

If Currently Unemployed, Type Unemployed

End Section

Education

High School Diploma? *

Yes

No

College Experience *

Masters

Bachelors

Associates

Some College Courses

None

Apprentice Training? *

Yes

No

If You Answered Yes To Apprentice Training, Please Explain *

If you answered no, please Type N/A If Not Applicable

List Educational Schools Attended With Degrees, Diplomas or Certificates Received *

If you answered no, please Type N/A If Not Applicable

End Section

References

List Name, Relationship & Phone Number of 1 References Not Related or Former Employers *

Reference 1

List Name, Relationship & Phone Number of 1 References Not Related or Former Employers *

Reference 2

List Name, Relationship & Phone Number of 1 References Not Related or Former Employers *

Reference 3

End Section

Prime Electric Company, Inc

Solicitation Hiring Policy

Loyalty Hiring Policy

In order for the Company to operate most effectively, it is important that all employees conduct our business under the highest standards of loyalty, integrity and ethics. There must be no outside personal interests which might conflict with the best interests of the Company, or which might influence an employee to accept any type of compensation or payment from a supplier, outside owner or "business competitor.

Employees may not engage in, directly or indirectly, either on or off the job, any conduct which is disloyal, disruptive, competitive, or damaging to the Company.

Employees may not accept any employment relationship with any organization that does business with, or competes with, the Company.
Outside employment that interferes with the employee job performance, working hours or progress is prohibited. Full time employees who wish to pursue outside employment must review the circumstances in advance with their supervisor to avoid. any possible conflicts. Supervisors are encouraged to contact the employee benefits coordinator for assistance on determining the appropriate resolution.
I have read the solicitation & loyalty hiring policies and I understand violation of any of these policies can and will be cause for my termination.

End Section

"I certify that the facts contained in this application are true and to the best of my knowledge, and understand that, if employed, Falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above, to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages, be terminated at any time without prior notice."

Digital Signature *

Date *

NOTICE: By Typing Your Full Name & Date Above, You Agree To This Notice.

End Section

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