Qualified applicants will be considered without regard to race, religion, color,
sex, national origin, age, disability or status as a disabled or Vietnam Era Veteran.
This application will be given every consideration; however, its receipt does not
imply that the applicant will be employed. Each question should be answered in a
complete and accurate manner as no action can be taken on this application until
all questions have been answered.
Position applied for (be specific):
How did you learn of this opening?
PERSONAL DATA
Name:
Home Phone:
Mobile Phone:
Email:
Mailing/Street Address:
City/State/Zip:
Are you over 18
years old?
If interviewed, would you be able to supply your Social Security Number at that
time?
Are you a U.S. Citizen or otherwise authorized to work in the United States on an
unrestricted basis? Proof of citizenship or immigration status will be required
upon employment.
Are you related to any Tri-County employee or Trustee?
If yes, to whom?
Have you been previously employed by Tri-County?
If yes, what was your position?
Have you ever been convicted of a felony?
If yes, please explain. Conviction will not necessarily disqualify an applicant
for employment.
Would you work full or part time?
Specify days and hours, if part time.
Are you willing to work overtime as required?
If your application is favorable, what date will you be available for work?
(mm/dd/yyyy)
Answer this question only after reviewing the applicable job description!
Are you able to perform the essential job functions with or without reasonable accommodation?
EDUCATION RECORD
MILITARY RECORD
Have you been in the U.S. Military?
If yes, what branch?
Rank at discharge?
Are you a Reservist?
If yes, please describe duties?
Summarize any special skills and/or qualifications acquired from employment or other
experience.
If applicable to the position you are seeking, indicate any special license you
hold.
Please include any information you think would be beneficial to Tri-County Electric
in considering you for employment.
It is important that all employed time be listed accurately. Begin with your present
or your last job. Account for all periods of time including military service and
any periods of unemployment.
PERSONAL REFERENCES
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY THEN TYPE YOUR NAME AND CLICK SUBMIT
TO AGREE TO TERMS.
- I hereby certify the statements and information in this application are true and
correct. I also understand that any false information contained herein shall be
considered as sufficient reason for rejection of this application or for dismissal
from employment if such false information is discovered after my employment with
Tri-County has already started.
- I authorize Tri-County to request information concerning me, my work habits, character
and skill from each former employer, references, firm and corporation identified
in this job application, except where otherwise indicated.
- I also expressly release all former employers, references, firms and corporations
identified in this job application from any and all liability in providing information
to Tri-County concerning me, my work habits, character and skill in connection with
this job application.
- I further understand that post-offer physical exams and drug tests are a condition
of employment and refusal to take such tests will subject me to termination.
- I understand that employment at Tri-County Electric Cooperative, Inc. is "at will"
which means that either I or Tri-County can terminate the employment relationship
at any time, with or without prior notice, and for any reason not prohibited by
statue. All employment is continued on that basis.
I, the undersigned, authorize Tri-County to request information concerning me, my
work habits, character and skill from each former employer, reference, firm and
corporation identified in this job application, except where otherwise indicated.
I also expressly release all former employers, references, firms and corporations
identified in this job application from any and all liability in providing information
to Tri-County concerning me, my work habits, character and skill in connection with
this job application.
I further understand that post-offer physical exams and drug tests are a condition
of employment and refusal to take such tests will subject me to termination.
Type your name in lieu of your signature then click submit to agree to the terms
above.
