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Please fill out the form below and click "submit."

Disclaimer:

Submitting this application does not guarantee employment.

Heritage Electric, Inc. may or may not be hiring at this time.

Applications are kept on file for 30 days.  
Personal Information:
Name (Last Name First): *
 Home Phone#: *
 Cell Phone#:
Address *
City *
 State *
 Zip Code *
Military Service (Yes/No):
 Branch:
 Rank:
 From/To:

Education: 

High School:
Name of School:
 Location of School:
 # Years
 Graduate?
College:
Name of School:
 Location of School:
 # Years
 Graduate?
Trade School:
Name of School:
 Location of School:
 # Years
 Graduate?
Former Employment:
Former Employer #1:
From/To:
 Name & Address of Employer:
Salary:
 Position:
 Reason For Leaving?
Former Employer #2:
From/To:
 Name & Address of Employer:
Salary:
 Position:
 Reason For Leaving?
Former Employer #3:
From/To:
 Name & Address of Employer:
Salary:
 Position:
 Reason For Leaving?
Former Employer #4:
From/To:
 Name & Address of Employer:
Salary:
 Position:
 Reason For Leaving?
Employment Desired:
Electrician/Helper
 Date You Can Start:
 Salary Desired:
Master Electrician License#
References:
Reference #1:
Name:
 Address:
Business:
 Years Known:
Reference #2:
Name:
 Address:
Business:
 Years Known:
Reference #3:
Name:
 Address:
Business:
 Years Known:

Authorization:

"I certify that the facts contained in this application are true and complete 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 and employers 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 the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company 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, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws".

Electronic Signature: *

Entering your name here will serve as an electronic signature stating that you agree with the "Authorization" statement above. Failing to enter your name here will invalidate this application.

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