CURRENTLY HIRING FOR REGIONAL SALES MANAGERS & INSTALLERS

APPLICATION FOR EMPLOYMENT         
AN EQUAL OPPORTUNITY EMPLOYER   

 PERSONAL INFORMATION

NAME (LAST NAME FIRST)    

S.S.#

PRESENT ADDRESS     

CITY, STATE, ZIP CODE 

PHONE #     POSITION     START DATE 

CURRENTLY EMPLOYED    YES    NO     CONTACT CURRENT EMPLOYER    YES    NO 

SALARY DESIRED    CURRENT SUPERVISOR'S NAME    

GRAMMAR SCHOOL    

HIGH SCHOOL   

COLLEGE    # OF YEARS    GRADUATE    YES    NO

MAJOR IN COLLEGE    

HOW DID YOU HEAR ABOUT US

FORMER EMPLOYER 
LIST MOST RECENT FIRST - 3 REQUIRED

COMPANY     

ADDRESS, CITY, STATE, ZIP CODE

JOB TITLE    START DATE    END DATE

SUPERVISOR NAME & TELEPHONE #

MAY WE CONTACT YOUR SUPERVISOR?    YES    NO

JOB DUTIES

REASON FOR LEAVING

COMPANY

ADDRESS, CITY, STATE, ZIP CODE

JOB TITLE    START DATE    END DATE

SUPERVISOR NAME & TELEPHONE #

MAY WE CONTACT YOUR SUPERVISOR?    YES    NO

JOB DUTIES

REASON FOR LEAVING

COMPANY

ADDRESS, CITY, STATE, ZIP CODE

JOB TITLE    START DATE     END DATE

SUPERVISOR NAME & TELEPHONE#

MAY WE CONTACT YOUR SUPERVISOR?    YES    NO

JOB DUTIES

REASON FOR LEAVING

REFERENCES
LIST 3 REFERENCES - WHO HAS KNOWN YOU FOR 5 YEARS - NOT RELATED TO YOU

NAME, ADDRESS, TELEPHONE #

NAME, ADDRESS, TELEPHONE #

NAME, ADDRESS, TELEPHONE #

MILITARY SERVICE
BRANCH OF SERVICE - DISCHARGE DATE - RANK

CONVICTED OF A FELONY WITHIN THE LAST 5 YEARS?    YES    NO

IF YES PLEASE EXPLAIN - WILL NOT EXCLUDE YOU FROM CONSIDERATION

ADDITIONAL INFORMATION
SKILLS - CLUBS - INTERESTS - ETC.

AUTHORIZATION
" I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION WILL RESULT IN DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE THE COMPANY SCHWARK ELECTRICAL INC. (S.E.I.) FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.

I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THIS COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE. I ALSO UNDERSTAND THAT IF HIRED FOR THE ABOVE POSITION I AM APPLING FOR, ANY AND ALL INFORMATION TO DO WITH SALES PROCEDURES AND INSTALLATION PROCEDURES WILL NOT BE DISCLOSED WHILE EMPLOYED BY S.E.I  OR UPON MY DISMISSAL AND OR RESIGNATION."

DATE

IF EMPLOYED
HARD COPY OF APPLICATION WILL BE SIGNED (S.E.I.)