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Personal Information

Position Applying For

First Name

Last Name

Primary Phone number

Secondary Phone Number

Email

Current Street Address

City

State

How Did you hear about Sirius Electrical Contractors LLC?

Employment Information

Citizenship/Work Status

U.S. Citizen Green Card Holder U.S. Work Permit/Visa Canadian Citizen Canadian Work Permit/Visa

Years of Work Experience Directly Related to the position you are applying:

Employment Type Desired

Full-Time Part-Time Temporary

When are you available to start work?

Criminal History

Have You Ever Been Convicted of a Felony or Misdemeanor?

NO YES

If yes, please explain:

Drivers License Information

Do you have a valid Drivers License?

YES NO

Do you have reliable transportation to and from work?

YES NO

Drivers License Number

State of Issue:

Do you have a clean driving record?

YES NO

Military Service

Have you ever been in the Armed Forces?

NO YES

If yes, which branch?

Are you currently a member of the National Guard or Reserves?

NO YES

Work History

If you have a resume, please upload here

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Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job title and duties performed:

May we Contact this employer?

YES NO

Work History

Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job Title and Duties Performed:

May We Contact this Employer?

YES NO

Work History

Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job Title and Duties Performed:

May We Contact this Employer?

YES NO

Electrical Industry Skills

What types of systems have you worked with? (e.g. High Voltage, Manufacturing equipment, fire systems)

What types of wiring have you worked with?

110

220

4160

480

Cat5

Coax

Fiber Optic

Phone

What specific parts, accessories have you worked with? (e.g 3-Way switches, lighting, control panel, etc.)

Do You have experience in Residential projects?

YES NO

Please list any extra job functions you have performed

What Certifications and Licenses do you have? (Select all that apply)

Journeyman License

Master Electrician License

Registered Professional Engineer

If yes, include state and license numbers for licenses selected above:

Reference #1

Name

Phone

Email

Position

Company

Reference #2

Name

Phone

Email

Position

Company

Reference #3

Name

Phone

Email

Position

Company

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Employment & Background Information

Last 3 Positions Held

Professional References

I certify that all the information is accurate and complete to the best of my knowledge and I understand that misleading or false statements will constitute sufficient cause for refusal

Personal Information

Position Applying For

First Name

Last Name

Primary Phone number

Secondary Phone Number

Email

Current Street Address

City

State

How Did you hear about Sirius Electrical Contractors LLC?

Employment Information

Citizenship/Work Status

Years of Work Experience Directly Related to the position you are applying:

Employment Type Desired

When are you available to start work?

Criminal History

Have You Ever Been Convicted of a Felony or Misdemeanor?

If yes, please explain:

Drivers License Information

Do you have a valid Drivers License?

Do you have reliable transportation to and from work?

Drivers License Number

State of Issue:

Do you have a clean driving record?

Military Service

Have you ever been in the Armed Forces?

If yes, which branch?

Are you currently a member of the National Guard or Reserves?

Work History

If you have a resume, please upload here

Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job title and duties performed:

May we Contact this employer?

Work History

Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job Title and Duties Performed:

May We Contact this Employer?

Work History

Name of Employer

Start Date (MM/DD/YYYY)

End Date (MM/DD/YYYY)

Starting Salary

Ending Salary

Phone

Job Title and Duties Performed:

May We Contact this Employer?

Electrical Industry Skills

What types of systems have you worked with? (e.g. High Voltage, Manufacturing equipment, fire systems)

What types of wiring have you worked with?

What specific parts, accessories have you worked with? (e.g 3-Way switches, lighting, control panel, etc.)

Do You have experience in Residential projects?

Please list any extra job functions you have performed

What Certifications and Licenses do you have? (Select all that apply)

If yes, include state and license numbers for licenses selected above:

Reference #1

Name

Phone

Email

Position

Company

Reference #2

Name

Phone