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Application Date* Date Format: MM slash DD slash YYYY PERSONAL INFORMATIONName* First Last Email* Cell Phone*Home PhoneAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Position Applying For*How did you hear about this job?*Are you legally eligible for employment in the U.S.?* Yes No Are you willing to work overtime?* Yes No Wage Expected*Age if under 18Date Available* Date Format: MM slash DD slash YYYY EDUCATIONHigh SchoolName and Location of School*Course of Study*Years Completed*Did You Graduate* Yes No Degree/Diploma*CollegeName and Location of School*Course of Study*Years Completed*Did You Graduate* Yes No Degree/Diploma*Vocational/Trade or Apprentice CoursesName and Location of School*Course of Study*Did You Graduate* Yes No Years Completed*Degree/Diploma*EMPLOYMENT HISTORYMOST RECENT EMPLOYERAre you currently working for this employer?* Yes No If yes, may we contact?* Yes No Company Name*Address* City State / Province / Region Phone*Start Date* Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Job Title*Supervisor's Name*Duties*Salary - Week/Month/Year*Reason(s) for leaving*SECOND MOST RECENT EMPLOYERCompany Name*Address* City State / Province / Region Phone*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Job Title*Supervisor's Name*Duties*Salary - Week/Month/Year*Reason(s) for leaving*THIRD MOST RECENT EMPLOYERCompany Name*Address* City State / Province / Region Phone*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Job Title*Supervisor's Name*Duties*Salary - Week/Month/Year*Reason(s) for leaving*EMERGENCY INFORMATIONPlease Provide Information of whom we may contact in case of an emergency.Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*REFERENCESFIRST REFERENCEName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Years Known*SECOND REFERENCEName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Years Known*JOB RELATED SKILLS AND REQUIREMENTSDo you have a valid driver's license?* Yes No DL #*Type*Have you ever been convicted of a felony?* Yes No Do you hold a journeyman electrician license or any other electrician license with any state, country, or municipality?* Yes No If yes, please list the license number(s), date(s) of license(s) and location of issue:Are you willing to take a drug test as required as part of your application?* Yes No Can you perform the requirements of this job with or without reasonable accommodation?* Yes No Have you had any general safety training?* Yes No If yes, describe:OTHER QUALIFICATIONSPlease list any other qualifications which you have had which you believe would be important for consideration by Swiftec, Inc.*NOTICE TO APPLICANTSSwiftec, Inc. does not require a pre-employment medical examination, but does reserve the right to require drug testing and a medical examination after an offer of employment is made to an applicant. All offers of employment are conditioned upon the passing of a drug test for the purpose of detecting the illegal use of drugs. Also, if an employment offer is made, you may be asked to answer certain medical questions. Medical examinations and answers to medical inquiries will be maintained on separate forms, and will be treated as confidential medical records. An applicant will not be excluded from employment unless they have medical conditions that prohibit their ability to perform the essential job functions of the position he or she desires with this Company. Swiftec, Inc. will make reasonable accommodations to aid handicapped applicants or employees fulfill essential job functions. Written job descriptions are available and will be furnished to applicants with this application.REPRESENTATIONS AND WAIVERSRead the following conditions. If you have any questions regarding the conditions, you should ask for an explanation or clarification from the employment interviewer. Signify your understanding and specific acceptance of each condition by your signature in the space provided at the end of the conditions. I hereby authorize Swiftec, Inc. to investigate any and all statements contained in this application. I herby consent to Swiftec, Inc. conducting any checks concerning my background which are deemed necessary, advisable, or helpful by Swiftec, In. (expect contacting my current employer, unless permission is granted above). I understand that if hired, I will receive a copy of Swiftec's rules and regulations and the company's policies, including it's drug policy. I will read and understand the rules, regulations, and policies; and I acknowledge that I will be required to abide by them. I understand that if hired, I may be required to submit drug test as part of this application procedure. I hereby consent to that drug test, agree to cooperate fully with that drug test, and waive any and all that I may be required to submit to a medical examination, if I am advised of a favorable employment decision. I hereby consent to such medical examination, and will fully cooperate with any required examination. I understand and agree that if this application results in employment, my employment can be terminated with or without cause and with or without notice, at any time, at the option of either Swiftec, Inc. or myself. I understand that no manager or any representative of Swiftec, Inc. has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing. I understand that due to the cyclical nature of the construction industry that Swiftec, Inc. is not in a position to employ field personnel on a permanent basis. I understand that although management makes every effort to accommodate conditions mandatory; overtime, a rotating work schedule, or a work schedule other than Monday through Friday. I understand and accept these as conditions of my continuing employment, I understand that employment is for no definite period of time and that Swiftec, Inc. can change wages, benefits and conditions at any time. I certify and guarantee that all statements made on this application are true and complete to the best of my knowledge and without mental reservations. I understand that falsification of this application may result in my not being considered for employment or, in the event I become employed by Swiftec, Inc., in my dismissal.Signature of Applicant (Type Name)*Date* Date Format: MM slash DD slash YYYY