Employment for Electrical Division

Full Name
Date
Address
City
State (Required)
Zip Code
Home Phone Number
Cell Phone Number
Other Phone Number
Your Email (required)
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Rate of Pay Requested per Hour:
Applying for Area Location Of
TucsonPhoenixOther (Please Specify)
Position you are applying for
ForemanJourneymanApprenticeLaborer
List how many years of total experience you have in the electrical trade:
Years in?
Commercial
Industrial
Residential
Pipe Bending
Are you willing to travel out of town to work:
List any days/hours you are UNABLE to work or reasons you might not other than sickness and why:
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For Insurance and Security Clearance Purposes
Do you have a valid Driver's License
Driver's License Number (Required)
State (Required)
Expiration
Do you have a clear driving record for the last 3 years
Do you have a CDL
Have you had a DUI or other serious infraction on your driving record
If Yes, please explain
Have you ever been convicted of a Felony or Misdemeanor other than a Traffic Violation
If Yes, please explain
Do you have your own personal and reliable transportation
Do you have insurance on your vehicle
How did you hear about this job:
Have you ever worked for Kelly Energy Inc. before
If yes, when
List any relatives or friends working for Kelly Energy Inc. now
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Personal Reference
Name
Relationship
Phone Number
Name
Relationship
Phone Number
Name
Relationship
Phone Number
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Education
High School
Date Graduation
college/University
Date Graduation
Degree/Major
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Employment History
Employer
Supervisor's Name
Phone Number
Starting Salary
Ending Salary
Starting Date
Ending Date
Job Title
Duties
Reason for Leaving

Employer
Supervisor's Name
Phone Number
Starting Salary
Ending Salary
Starting Date
Ending Date
Job Title
Duties
Reason for Leaving

Employer
Supervisor's Name
Phone Number
Starting Salary
Ending Salary
Starting Date
Ending Date
Job Title
Duties
Reason for Leaving

Military Service
YesNo
Branch/Dates of Service/MOS/Other Information
Have you completed an accredited Electrical Apprenticeship Program?
YesNo
Have you completed any other accredited program related to the Electrical Industry?
YesNo
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If you are applying for a position as an Apprentice
Kelly Energy Inc. offers an accredited I.E.C.A. 4 year Apprenticeship Program
Are you interested in applying for enrollment in this program?
YesNo
Please list any other schooling/skills/special training you have had
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Applicants Statement
I certify that my answers on this application are true and correct.

If employed, I understand that any false or misleading information or statements given in my application or during my interview may result in my immediate dismissal.

By signing below, I hereby authorize Kelly Energy Inc. to verify the information I have given on this application and to contact any previous employers and references listed on this application unless specifically noted below: ( List anyone you do not want us to contact, and the reason why )

Upload Your Resume (Please upload only PDF or Word Documents)
Applicant's Digital Signature
Date