Employment Application

EMPLOYMENT APPLICATION

We are an equal opportunity employer.

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Date Submitted:

Position Applied For:

Please indicate other position not listed above.

How did you learn about us?

Employment Agency

Friend

Inquiry

Relative

Other…

Your Information

First Name

Last Name

Phone Number:

Email:

Address

City/Town

State/Province

ZIP/Postal Code

Your Preferences

Best time to contact you at home is?

Are you 18 years of age or older?

Yes

Do you have a valid Class D driver’s license?

Yes

State and License Number:

Do you have a commercial driver's license (CDL)?

Yes

Class, State, and License Number:

Are you related by blood or marriage to any REC employee or a member of the REC board of trustees?

Yes

Name of relative(s):

Name of relative(s):
Name of relative(s):

Are you legally eligible to work and live in the United States? (Proof of Citizenship or immigration status will be required upon employment).

Yes

Have you ever been employed with us before?

Yes

Date of previous employment:

Have you ever been convicted of a Felony?

Yes

Are you willing to relocate if the job requires it?

Yes

Are you willing to travel as part of your job duties?

Yes

Are you willing to work overtime when required by the job?

Yes

Education

Education History

Type of School	Name	Address	City	State	Course of Study	No. of Years Completed	Diploma/Degree
Type of School	Name	Address	City	State	Course of Study	No. of Years Completed	Diploma/Degree (or equivalent)
Type of School	Name	Address	City	State	Course of Study	No. of Years Completed	Diploma/Degree (or equivalent)
Type of School	Name	Address	City	State	Course of Study	No. of Years Completed	Diploma/Degree (or equivalent)
Type of School	Name	Address	City	State	Course of Study	No. of Years Completed	Diploma/Degree (or equivalent)

Describe any specialized training, apprenticeship, skills and extra-curricular activities.

Military Service Record

Branch	Starting Date	Ending Date	Rank at Discharge	Discharge Type
Branch	Starting Date	Ending Date	Rank at Discharge	Discharge Type
Branch	Starting Date	Ending Date	Rank at Discharge	Discharge Type
Branch	Starting Date	Ending Date	Rank at Discharge	Discharge Type
Branch	Starting Date	Ending Date	Rank at Discharge	Discharge Type

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employment History

Employer	Address	Telephone	Job Title	Supervisor	Reason for Leaving	Starting Date	Ending Date	Starting Hourly Rate	Final Hourly Rate	Work Performed	May we contact this employer?
Employer	Address	Telephone	Job Title	Supervisor	Reason for Leaving	Starting Date	Ending Date	Starting Hourly Rate	Final Hourly Rate	Work Performed	May we contact this employer?
Employer	Address	Telephone	Job Title	Supervisor	Reason for Leaving	Starting Date	Ending Date	Starting Hourly Rate	Final Hourly Rate	Work Performed	May we contact this employer?
Employer	Address	Telephone	Job Title	Supervisor	Reason for Leaving	Starting Date	Ending Date	Starting Hourly Rate	Final Hourly Rate	Work Performed	May we contact this employer?
Employer	Address	Telephone	Job Title	Supervisor	Reason for Leaving	Starting Date	Ending Date	Starting Hourly Rate	Final Hourly Rate	Work Performed	May we contact this employer?

References

Reference Contact Info

Use the +/- to add or remove additional contacts.
Reference Contact Info Name Company Phone Address City/Town State/Province ZIP/Postal Code
Reference Contact Info Name Company Phone Address City/Town State/Province ZIP/Postal Code
Reference Contact Info Name Company Phone Address City/Town State/Province ZIP/Postal Code

Your Resume

Attach resume file

Paste your resume

One file only.
5 MB limit.
Allowed types: txt, doc, docx, pdf.

Signature

Applicant's Statement

I understand my employment will be subject to satisfactorily passing a post job offer medical exam and a preemployment drug screen test. In addition, if the position requires operation of a company vehicle I understand that a valid Driver’s License and a satisfactory motor vehicle report is an additional requirement before employment. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies of your choice.

I certify that all the answers I have given and statements I have made are true and correct. I authorize my previous employers and references to furnish any information requested concerning my personal character, work habits or employment records. I release all such persons from liability or damages incurred as a result of inquiry and furnishing this information. I understand that, if hired, any material omission or misrepresentation of facts furnished by me in this application or physical examination will be sufficient cause for discharge. I also understand that, if employed, my employment shall not be for any specific term and that I may terminate my employment at any time I choose on proper notice. I also understand that Rural Electric Cooperative may terminate my employment at its discretion with or without cause.

I Agree To The Above Statement

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