Employment

First Name*

Middle Name

Last Name*

Street Address*

City*

State*

Example: FL

Zip Code*

Phone

Email

Social Security #*

Example: 123-45-6789

Date of Birth*

Driver's License #*

Ex: C123-456-78-912-3

Issuing State*

Ex: FL

Are you a legal citizen of the United States?*

Yes
No

If no, are you legally allow to work in the US?

Yes
No

Have you worked for Lawson & Lawson Electrical Services, Inc before?*

Yes
No

If yes, please list dates:

Have you applied with Lawson & Lawson Electrical Services, Inc before?

Yes
No

If yes, please list dates:

Can you perform the essential functions of the job(s) for which you are applying?*

Yes
No

Have you ever been convicted of a crime, adjudicated withheld or received a verdict of anything other than not guilty in any criminal investigation or proceeding?*

Yes
No

If yes, describe when the conviction occurred; the facts and circumstances, and any facts pertaining to rehabilitation. (Do not list any criminal charges for which the records have been expunged. A criminal offense will not necessarily bar employment.):

Name of your high school*

Did you graduate high school?*

Yes
No

Name of your college*

Did you graduate college?*

Yes
No

Please list below any special skills, qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking:*

Please list (3) non-relatives who are familiar with your qualifications, work history and ability.*

Name, Relationship, Years known, Phone number

Are you employed now?*

Yes
No

May we contact your present employer?*

Yes
No

If no to either of the above two questions, why?

Please describe your most recent employment experience:*

Name of employer, your position, your supervisor's name, their phone number, your starting salary, your ending salary, and the dates you were employed for.

Please describe your SECOND most recent employment experience:*

Name of employer, your position, your supervisor's name, their phone number, your starting salary, your ending salary, and the dates you were employed for.

Please describe your THIRD most recent employment experience:*

Name of employer, your position, your supervisor's name, their phone number, your starting salary, your ending salary, and the dates you were employed for.

Please describe your FOURTH most recent employment experience:*

Name of employer, your position, your supervisor's name, their phone number, your starting salary, your ending salary, and the dates you were employed for.

Date*

Today's Date:

If you have any questions, please feel free to contact us at 850-562-4111.

Signature*

LAWSON & LAWSON
ELECTRICAL SERVICES, INC.

LLE–EmploymentApplication