Employment Application Phone (803) 547-7799 Hours Mon-Fri 7AM-4PM Step 1 of 6 16% Your Personal InformationDate MM slash DD slash YYYY Name First and Last Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Your PhoneReferred By Your Email Address Enter Email Confirm Email Position Applying For Wage Desired Date You Can Start MM slash DD slash YYYY Are you over the age of 18? Yes No If yes, state your age:Please enter a number from 0 to 100.Do you have a valid driver's license? Yes No Additional InformationAre you willing to work, as necessary:Overtime? Yes No Weekends? Yes No Out of town overnight (Mon-Fri)? Yes No Are you willing and able to perform, in a reasonable and safe manner, all the activities involved in the position for which you have applied? Yes No If no, please explain:Have you been convicted of a crime within the last 10 yeaars (excluding minor traffic violations) including driving under the influence of alcohol or drugs?A conviction record will not necessarily be a bar to employment. This information will be used for job-related purposes and only the extent permitted by law. Yes No If yes, state the nature of the offense, when, where and disposition: Previous EmploymentEmployment HistoryList in order, last or current employer first. Account for any gaps in your employment.Employer NameTelephoneAddressSupervisorDates EmployedRate of Pay (starting and ending)Position HeldReason for LeavingDuties Add Remove Special SkillsElectrical Skills/Knowledge:Construction Trade:Heavy Equipment/Specialty Tool Proficiency:Please describe why you are interested in working for our company and to list any other skills and abilities that you feel especially qualify you for a position with us. In case of emergency, who should be notified?In case of emergency, who should be notified?NameTelephoneAddressRelationship Add Remove Agreement (Please read carefully before signing) I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Brilin Electric creates an actual or implied contract of employment. I understand that, if I accept employment with Brilin Electric, it will be at an at-will basis. This means that either Brilin Electric or I have the right to terminate the employment at any time, for any reason, with or without cause. I agree to submit to drug and alcohol testing. If requested by Brilin Electric, I release Brilin Electric, and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. I authorize Brilin Electric to investigate information concerning my education, employment experiences, and all other aspects of my background relevant to my proposed employment. I release Brilin Electric and its employees from all liability arising from such an investigation.Signature Upload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB. Brilin Electric considers all applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with Federal laws prohibiting discrimination in employment. Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with such laws, Brilin Electric will verify the status with every individual offered employment with the company. In the connection, all offers of employment are subject to verification of the applicant's identity and employment authorization, and it will be necessary for you to submit such documents as required by law to verify your identification and employment authorization upon employment. The undersigned acknowledges as a condition of their employment, that the employer, Brilin Electric, may require their services in the operation of vehicles that are owned, leased, or rented by the employer. In that, it is reasonable and prudent that the employer restricts the use of such vehicles to employees with acceptable driving records. The undersigned authorizes the employer and the agent to secure copies of the applicant's Motor Vehicle Report. The information in that report can and will be shared by the employer, their agent, and various insurance companies for the exclusive purpose of evaluating their records and determining their acceptability as a vehicle operator.Applicant Witness Date Date SignatureSignatureFull name Date of Birth D.L. Number State of Issue Δ