* indicates required field
Personal Information
Last Name: *
Date: *
First Name *
Middle Initial *
    
Address Line 1: *
Home Phone: *

Address Line 2:

Cell Phone: *
City: *
State: *
ZIP: *
email address: *
Do you have the right to work in the U.S.?: *
Do you have a valid driver's license (DL) ?:
Do you have a class CDL license?: Yes No
DL Number: *
DL State: *
Have you ever been convicted of a DUI:
If applying for a technician position, are you over 21 years of age?
Are you a veteran:
If applying for a lighting technician or other electrical position, what level of electrical knowledge/experience do you possess?
How would you rate your knowledge of lighting and associated products?

 

Education
High School:
Location:
Complete Degree?

H.S. GED?:

College/University:
Location:
Complete Degree?

Degree:
If No, how many years did you complete in College/University:
Other Training (Including vocational school and/or technical school, etc.)

 

Employment
Specific Position for which you are applying for: *
Minimum wage expected ( $10 / hr or $32,000 / yr ): *
Can you Travel?:

*

Can you work Various Shifts?:

*

List any special skills that you may have (i.e., heavy equipment, office machines, etc.) :
If presently employed, show days and hours you work: Sun Mon Tues Wed Thur Fri Sat
Hours:
or Shifts
1st 2nd 3rd

 

EMPLOYMENT RECORD * Required field (If it does not apply, type N/A)
List employment beginning with present job. (Including any military experience)
Current/Recent Employer:
*
City, State:
Job Title:
Phone Number:
*
Start Date:
*
End Date:
*
Duties:
Wages:
Reason for Leaving:
Employer 02 :
*
City, State:
Job Title:
Phone Number:
*
Start Date:
*
End Date:
*
Duties:
Wages:
Reason for Leaving:
Employer 03 :
*
City, State:
Job Title:
Phone Number:
*
Start Date:
*
End Date:
*
Duties:
Wages:
Reason for Leaving:
Employer 04:
City, State:
Job Title:
Phone Number:
Start Date:
End Date:
Duties:
Wages:
Reason for Leaving:
Employer 05:
City, State:
Job Title:
Phone Number:
Start Date:
End Date:
Duties:
Wages:
Reason for Leaving:
May we contact your current Employer?: *

Have you ever pled guilty or "no contest" to a crime before?: *

If yes, give details of each.:
Note: answering 'yes' to this question does not consititute an automatic bar to employment.
Details of crimes:
How did you hear of NES?: *
Name of Referral:
Do you know someone who has the experience that NES is seeking, i.e. electricians or leads who could travel and be a part of our company?
Name
Phone
Name
Phone

 

Professional References
List at least THREE SUPERVISIORS familiar with your work or job-related skills
Employer's Name: *
Position Held:
Company Name and Address:
Phone Number:
Employer's Name:
Position Held:
Company Name and Address:
Phone Number:
Employer's Name:
Position Held:
Company Name and Address:
Phone Number:
Employer's Name:
Position Held:
Company Name and Address:
Phone Number:

 

WE ARE AN EQUAL OPPORTUNITY EMPLOYER
Applicant's Statement

I understand that if I am hired, my employment will be for no definite period, regardless of the period of payment of my wages. I further understand that I have the right to terminate my employment at any time with or without notice, and the Company has the same right.

I understand that the Company reserves the right to require me to submit to a pre-employment drug test at any time and also reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law. I consent to the release of the results of any such test(s) to the Company.

I understand that the Company may investigate my driving record, my criminal record and my credit history, and that an investigative consumer report may be prepared whereby information is obtained through personal interviews with neighbors, friends and others with whom I am acquainted. This inquiry would include information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written requ est with a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

I further understand that the Company may contact my previous employers. I authorize those employers to disclose to the Company all records and other information pertinent to my employment with them, and I release them from liability for providing such information. I also authorize the Company to provide truthful information concerning my employment with it to my prospective employers and I agree to release the Company from liability for providing such information .

I certify that all of the information I provide on this application and in my interview will be true and accurate. I understand that if any such information is found to be false or misleading in any respect, I will be disqualified from consideration for employment or subject to immediate dismissal if I am already employed.

 
By clicking the submit button, You agree and understand the previous "Applicant's Statement".