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Our Services
About
Careers
Apply Now
Contact Us
Apply Now
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4
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How do we contact you?
Name
(Required)
Social Security#
(Required)
Mailing Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Home Phone
(Required)
Mobile Phone
(Required)
Education
Location
Diploma
Other (Specify)
Highest Grade Completed
College
Years Completed
Job-related Training and Course work
List any skills, licenses and certificates which are related to the job you seek (including typing speed and computer proficiencies)
Job-related Training and Course work
Name of present or last employer
Address
Phone
Job Title
Supervisor’s Name
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Hours per Week
Salary
May we contact this employer
Yes
No
Job duties (give details):
Reason for leaving:
B&C Utilities, Inc. has permission to contact my former employer for references.
Do you possess a valid driver’s license?
(Required)
Yes
No
If yes, provide
(Required)
State
Expiration
Number
Class
A
B
C
D
Conviction of a criminal offense is not a bar to employment in all cases. Each conviction is evaluated individually.
Have you ever been convicted of a felony offense?
(Required)
Yes
No
If yes, please list charge(s)
(Required)
Where convicted
(Required)
Date
(Required)
MM slash DD slash YYYY
Disposition/Status
(Required)
Have you ever been terminated or forced to resign from any job?
(Required)
Yes
No
If yes, explain
(Required)
Are you legally authorized to work in the United States?
Yes
No
References
Give the names of 2 (two) people, not related, who are familiar with your work.
Name
Address
Phone
Name
Address
Phone
Emergency Contact Information
Name
Relationship
Phone Number
Name
Relationship
Phone Number
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