Suncoast Electric | Employee Application

Personal Information

Date

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Last 4 Digits of Your SS #

DOB

Do you have any previous job injuries?

Yes
No

If yes, please explain and list date of injury below.

Previous Job Injuries

Have you ever been convicted of a felony or have been incarcerated in connection with a felony?

Yes
No

If yes, please explain below

Further details on felony

References

Name #1

Phone #1

Address #1

Name #2

Phone #2

Address #2

Employment History

Name of Company

Address

Phone #

Contact Person

Wages

Dates of Employment

Title and Job Duties

Reason for Leaving

Name of Company

Address #1

Phone #

Contact Person

Wages

Dates of Employment

Title and Job Duties

Reason for Leaving

Name of Company

Address #1

Phone #

Contact Person

Wages

Dates of Employment

Title and Job Duties

Reason for Leaving

Job Certifications/Training/Schools

Type: Certification

Certified By

Date

Type: Certification

Certified By

Date

Trade References

Name

Number

Name

Number

Name

Number

Education - Did you Graduate?

Yes
No

If Yes, When?

From What School?

Did you attend college?

Yes
No

If Yes, then what college?

Did you attend any trade related schools?

Yes
No

If Yes, What School?

List Any Special Skills

I certify that the information provided in my application for employment with Sun Coast Electric is true and complete to the best of my knowledge. I authorize the investigation of all matters contained in this application and hereby give Sun Coast Electric permission to contact schools, previous employers, references, and others. I hereby release the Employer from any liability as the result of such contact. I understand that misrepresentations, omissions of fact or incomplete information provided on my application or resume may remove me from further consideration for employment. In addition, if I am employed, I understand that any misrepresentation or omissions of fact on my application or resume may subject me to discipline, up to and including discharge, at any time without any previous notice.*

Agree