Personal Information

• Full Name: *
• Date of Birth: *
• Street Address: *
• City: *
• State: Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
• Zip Code: *
• Phone #: *
• Email: *
• Confirm Email: *
• Referred by: *

Employment Desired

Education

Subjects of special study or research work:

Job related skills:

Professional References

Please supply the name and contact information for two supervisors or co-workers from previous employment.

• Name:
• Company:
• Position:
• Phone:

• Name:
• Company:
• Position:
• Phone:

Previous Employer

Please supply the name and contact information for two supervisors or co-workers from previous employment.

• Currently Employed? NO YES
• Most Recent Employer: *
• Your Position: *
• Supervisor Name/Phone #: *
• May we call for reference? NO YES

Resume/Additional Information

STATEMENT (Please read this statement carefully before signing this application):

I understand that employment with TRAVCO ELECTRIC is at-will, meaning that I or TRAVCO ELECTRIC may terminate my employment at any time, or for any reason consistent with applicable state or federal law.

I authorize TRAVCO ELECTRIC to conduct a thorough background investigation· of my work and personal history, and verify all data given on this application and during interviews. I hereby release the Organization, and its representatives or agents, from any liability that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information.

I understand that TRAVCO ELECTRIC requires the successful completion of a drug and/or alcohol test as a condition of employment.

I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire.