E-mail Address: * Employment Desired * Full-Time Part-Time Temporary Position Applied For Date Referral Source * Newspaper Ad School Posting Walk-In L&S Employee Other Date available to begin work * Salary expected Name Address * City * State * Zip Code * Telephone Number * Social Security Number Are you 18 years of age or older? * Choose Yes No Are you legally eligible for employment in this country? * Choose Yes No Are you willing to undergo a drug screen and physical exam upon conditional offer of employment? * Choose Yes No Have you been convicted of a felony in the past seven years? * Choose Yes No If yes, explain Have you ever been employed by L&S Electric, Inc.? * Choose Yes No If yes, give dates of employment Are you currently on lay-off status subject to recall? * Choose Yes No Indicate the days and shifts you are available to work * YesMonday * Choose First Shift Second Shift Overtime Tuesday * Choose First Shift Second Shift Overtime Wednesday * Choose First Shift Second Shift Overtime Thursday * Choose First Shift Second Shift Overtime Friday * Choose First Shift Second Shift Overtime Saturday * Choose First Shift Second Shift Overtime Sunday * Choose First Shift Second Shift Overtime From your work, education, or experience, are you qualified in any of the following? Electrical Wiring * Choose No Experience Working Knowledge High Level Skill Electrical Assembly Choose No Experience Working Knowledge High Level Skill Electrical Testing * Choose No Experience Working Knowledge High Level Skill Welding * Choose No Experience Working Knowledge High Level Skill Control Panel Wiring * Choose No Experience Working Knowledge High Level Skill Power Hand Tools * Choose No Experience Working Knowledge High Level Skill Machining * Choose No Experience Working Knowledge High Level Skill Blueprint reading * Choose No Experience Working Knowledge High Level Skill CAD drafting * Choose No Experience Working Knowledge High Level Skill Building maintenance * Choose No Experience Working Knowledge High Level Skill Grounds maintenance * Choose No Experience Working Knowledge High Level Skill AC Motor Repair * Choose No Experience Working Knowledge High Level Skill DC Motor Repair * Choose No Experience Working Knowledge High Level Skill Electronics Testing * Choose No Experience Working Knowledge High Level Skill Employment History May we contact your present employer? * Choose Yes No May we contact your past employers? * Choose Yes No Please list all employment starting with present or most recent employer. Account for all periods, including unemployment and military service. (You may cut and paste from your resume) * Education and Training List the your education and training, name of school attended, location, years attended, if you graduated, and what degree(s) youve earned. (You may cut and paste from your resume) * Clerical Skills Typing Speed 10-key calculator operation by touch? Choose Yes No Dictation equipment (words per minute) List types of computers/business machines you can operate proficiently. Types of software able to use proficiently * Other * Applicants Statement Your Name Todays Date *
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* Required