Online Application

Name:	Date:
Address1:
Address2:
City:	State: Zip:
Phone:	SSN#
Email:
How would you describe your Health? Excellent Good Fair
Do you have any physical problems or handicaps? yes no If yes please explain below:

Have you ever been injured on a job? yes no If yes please explain below:

Position for which you are applying:
Do you have a car available for work? yes no
Do you have your electrician's hand tools? yes no
Years experience: Industrial Commercial Residential
Do you have Rigid Conduit experience? yes no If yes how much?
Do you have Controls experience? yes no If yes how much?
Relative education or trades training:

Hobbies or special interests:

When can you start? Wages Expected (Per Hour):
Employment History
Company: Phone:
Address:
Employment dates: From To
Position Held:
Reason for leaving:
Responsibilities:

Company: Phone:
Address:
Employment dates: From To
Position Held:
Reason for leaving:
Responsibilities:

Company: Phone:
Address:
Employment dates: From To
Position Held:
Reason for leaving:
Responsibilities:

Shuler Electric Inc. Industrial and Controls 2400-A Reliance Avenue - Apex, NC 27539 Phone:(919)362-0007 Fax:(919)362-0777