ELECTRICAL CONTRACTOR

RESIDENTIAL  ●  COMMERCIAL  ●  INDUSTRIAL

679 Mohawk Trail
Shelburne, Massachusetts

(413) 625-6356

Employment Application

Federal and State law requires that all applications be considered without regard to race, color, sex, age, or national origin. We believe in, and fully support equal employment opportunity and will fulfill our obligation to the fullest.

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Name
Address
Date of Birth
Any physical handicaps? If yes, what is the handicap?
Have you ever been convicted of a crime? If you have been convicted of a crime please describe, and please state when you were convicted of a crime.
Have you worked here before?

Previous Employment

Address
Hire Date
End Date
Address
Hire Date
End Date

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