Employment Application

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Please enter your email, so we can follow up with you.

Position Applied For:

Date Available

Desired Salary

Are You Willing To Work Overtime?

Yes
No

Are You A Citizen Of The United States

Yes
No

Have You Ever Worked For Lenhart Electric Before?

Yes
No

Have You Ever Been Convicted Of A Felony?

Yes
No

Have You Used Illegal Drugs In The Past 6 Months?

Yes
No

Education and Training

High School

Address

Address Line 1

Address Line 2

City

State

Zip Code

From (Date)

To (Date)

Did You Graduate?

Yes
No

Trade School

Address

Address Line 1

Address Line 2

City

State

Zip Code

From (Date)

To (Date)

Did You Graduate?

Yes
No

College

Address

Address Line 1

Address Line 2

City

State

Zip Code

From (Date)

To (Date)

Did You Graduate?

Yes
No

References

Please list three professional references. Do not list relatives or personal friends.

Name

First

Last

Relationship

Company

Phone

Name

First

Last

Relationship

Company

Phone

Name

First

Last

Relationship

Company

Phone

Previous Employment

Company

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Supervisor

First

Last

Job Title

Ending Salary

Responsibilities

Are You Still Working At This Company?

Yes
No

From (Date)

To (Date)

May We Contact Your Previous Supervisor For A Reference?

Yes
No

Company #2

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor

First

Last

Job Title

Ending Salary

Responsibilities

From (Date)

To (Date)

Reason for Leaving

May We Contact Your Previous Supervisor For A Reference?

Yes
No

Company #3

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor

First

Last

Job Title

Ending Salary

Responsibilities

From (Date)

To (Date)

Reason For Leaving

May We Contact Your Previous Supervisor For A Reference?

Yes
No

How Did You Hear About Us?

If A Referral, Who Referred You?

If Other, How Did You Hear About Us?

Additional Documentation

Upload Your Resume

Click or drag a file to this area to upload.

pdf, doc, docx

Upload Any Additional Documents

Click or drag a file to this area to upload.

pdf, doc, docx

Upload Any Additional Documents

Click or drag a file to this area to upload.

pdf, doc, docx

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge authorize my former employers to furnish all information pertaining to my work record. I hereby release my former employers from all liability on account of furnishing such information. I understand that if employed, false statements, omissions or misleading statements on this application, regardless of the time they are discovered, shall be considered sufficient cause for dismissal. I also agree that my employer shall not be held liable in any respect if my employment is terminated because of such omissions or false or misleading statements. The company is hereby authorized to investigate my employment history, including contacting employers listed and to verify my education and training. Consumer reports may be obtained as part of the application/employment evaluation of my job application/employment. The reports may be procured by our current insurance company and may include my driving record, an assessment of my insurability under the company’s insurance coverage’s or other consumer reports. By signing this disclosure, I hereby authorize the company to procure such reports and additional reports from me from time to time as it deems appropriate, to evaluate my insurability or for other permissible purposes.

Driver's License Number *

Social Security # *

Digital Signature (type your name) *

Name *

First

Last

Date *