ONLINE EMPLOYMENT APPLICATION

Thank you for taking the time to submit an application for employment with Cook Electrical, Inc. After completing all the fields below and submitting your application, our office will contact you if we would like to set an appointment for a formal interview. Please note, if an interview appointment is set, you will be asked to supply additional information once you arrive in our office. If you have any questions about the application process, please contact our office at 904.696.1017. Again, thank your for your time.

First Name:

Middle Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Home Phone:

Alternate Phone:

Email Address:

Emergency Contact:

Emergency Phone:

How did you hear about Cook Electrical?

Have you ever pled guilty or nolo contendere to or been convicted of a crime?
(Conviction or guilty plea or plea of nolo contendere is not necessarily a bar to employment.)
Yes     No

If yes, describe in full including date(s):

Do you have a legal right to work in the United States?
Yes     No

Position Applying For:
Licensed Electrician
Enter State/County:
Mechanic
Electrical Helper
Apprentice
Other Position
If Other, enter Position Name:

Desired Pay:

Education

High School

School Name & Address:

Years Completed:
9th     10th     11th     12th

Diploma or Degree:

Describe Course Of Study:

Trade, Business, Vocational

School Name & Address:

Years Completed:
1     2     3     4

Diploma or Degree:

Describe Course Of Study:

College/University

School Name & Address:

Years Completed:
1     2     3     4

Diploma or Degree:

Describe Course Of Study:

Graduate/Professional

School Name & Address:

Years Completed:
1     2     3     4

Diploma or Degree:

Describe Course Of Study:

List any special skills/training you have relevant to the position you are applying for:

Previous Employment

(List the most recent employment first.)

Employment #1

Employer:

Employment Dates:

From:    To:

Last rate or pay:

Phone:

Supervisor's Name:

Address:

Job Title:

Reason For Leaving:

Give full description of your duties and work performed:

Employment #2

Employer:

Employment Dates:

From:    To:

Last rate or pay:

Phone:

Supervisor's Name:

Address:

Job Title:

Reason For Leaving:

Give full description of your duties and work performed:

Employment #3

Employer:

Employment Dates:

From:    To:

Last rate or pay:

Phone:

Supervisor's Name:

Address:

Job Title:

Reason For Leaving:

Give full description of your duties and work performed: