Application - Denny's Electric LLC

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Employment Application

Denny's Electric LLC

"*" indicates required fields

Date*

Name*

First Middle Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Are you a citizen of the United States?*

Yes

No

If no, are you authorized to work in the United States?*

Yes

No

If so, when:*

Emergency Contact Name*

Phone*

Relation*

EMPLOYMENT DESIRED

Position Applying For*

Date Available*

Desired Wage

Ever applied to this company before?*

Have you ever been convicted of a Felony?*

Yes

No

If yes, please explain:*

EDUCATION

High School*

Address*

Years Attended*

Did you graduate?*

Yes

No

College

Address

Years Attended

Did you graduate?

Yes

No

Degree

Other

Address

Years Attended

Did you graduate?

Yes

No

Degree

MILITARY SERVICE

Military Branch

From:

To:

Rank at discharge:

Type of discharge:

If other than honorable, please explain:

PREVIOUS EMPLOYMENT

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Which of these jobs did you like the best?

How did you hear about Denny's Electric, LLC?

REFERENCES

Reference #1*

First Last

Relationship*

Company*

Phone*

Reference #2*

First Last

Relationship*

Company*

Phone*

Reference #3*

First Last

Relationship*

Company*

Phone*

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Certify*

I Certify

I CERTIFY THAT MY ANSWERS ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. IF THIS APPLICATION LEADS TO EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION IN MY APPLICATION OR INTERVIEW MAY RESULT IN MY RELEASE.

DENNY’S ELECTRIC, LLC IS AN EQUAL OPPORTUNITY EMPLOYER