Job Application
APPLICATION FOR EMPLOYMENT
Laminack Electric Co., Inc.
3576 HWY 78
HEFLIN, AL 36264
PH# 256-463-3222
FAX# 256-463-3225
PERSONAL INFORMATION DATE OF APPLICATION:______________
Name:
Last First Middle
Address:
Street (Apt) City, State Zip
Alternate Address:
Street City, State Zip
Contact Information: ( ) ( )
Home Telephone Mobile Email
How did you learn about our company?
POSITION SOUGHT: _________________________ Available Start Date:______________
Desired Pay Range: ________________ Are you currently employed? _________________
By Hour or Salary
EDUCATION
Name and Location Graduate? – Degree? Major / Subjects of Study
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High School
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College or University
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Specialized Training,
Trade School, etc…
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Other Education
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Please list your areas of highest proficiency, special skills or other items that may contribute to your abilities in performing the above mentioned position.
Are there any reason’s that you can not receive a U.S. Government Security Clearance?
YES – ____________
NO – ____________
IF YES PLEASE EXPLAIN -
PREVIOUS EXPERIENCE
Please list beginning from most recent
Dates Employed Company Name Location Role/Title
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Job notes, tasks performed and reason for leaving:
Dates Employed Company Name Location Role/Title
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Job notes, tasks performed and reason for leaving:
Dates Employed Company Name Location Role/Title
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Job notes, tasks performed and reason for leaving:
Dates Employed Company Name Location Role/Title
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Job notes, tasks performed and reason for leaving: