J. RANCK ELECTRIC, INC. APPLICATION Step 1 of 4 25% HiddenApplicant StatusSelect a StatusSent On To Appropriate JRE EmployeeIn Interview ProcessNot InterestedRejectedEmailed for More InformationLeft VM for More InformationLeft VM for Interview Set UpHiredFound Other JobSent information on union processFiled, no action neededRejection letter sentApplicant Name:* First Last Have you worked under another name(s):* Yes No Alternate Name:* First Last Position Desired: Schedule Desired:*Check all that apply Full Time Part Time When can you begin work?* MM slash DD slash YYYY Applicant Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you lived at the above address?* Primary Phone Number:*Type:* Cell Home Work Alternate Phone Number:Type: Cell Home Work Email:* Enter Email Confirm Email How did you learn about this job opportunity?*Select all that apply Union referral Newspaper ad jranck.com Website other than jranck.com JRE employee recommendation Other Union local:* Name of newspaper:* Name of website where you learned of this opportunity:* Name of JRE Employee who referred you to this opportunity:* Please explain where you found this opportunity:* Do you have adequate transportation to and from work?* Yes No Do you have a valid driver's license?* Yes No Driver’s License Number:* Issuing State:* AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Restrictions:* License Type:* Operator/Driver Chauffeur Commercial CDL Class:* Class A Class B Class C Endorsement(s):*select all that apply X H N T S P F None How long have you held your CDL?* Less than one year One or more years Have you ever worked for this company before?* Yes No From Date:* MM slash DD slash YYYY To Date:* MM slash DD slash YYYY Previous Postion:* Are you legally eligible to work in the United States?* Yes No Are you able to perform the essential functions of the job for which you are applying, with or without accommodation(s)?* Yes No CRIMINAL INFORMATIONNote: Answering “yes” to these questions does not constitute an automatic bar to employment. Factors such as the applicant’s age and year of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. Do not include minor traffic citations and arrests or convictions which have been sealed or expunged.1. Have you ever had a license or permit revoked or suspended?* Yes No Details:* 2. Have you ever pled guilty, or no contest to, or been convicted of a felony?* Yes No Details:* 3. Have you ever tested positive or refused to comply with a pre-employment, post-accident, random, or reasonable suspicion drug or alcohol test for any employer for which you have worked in the past 3 years?* Yes No Details:* EDUCATION & TRAINING INFORMATIONHighest Education Completed:*Elementary or middle schoolSome high school, no diplomaHigh school graduate, diploma or the equivalent (for example: GED)Some college credit, no degreeTrade/technical/vocational trainingAssociate degreeBachelor’s degreeMaster’s degree or higherAre you currently in school?* Yes No School Details:*Use the space below to provide school name, location, graduation date or expected graduation date (if applicable), and your major course of study (if applicable). Would you like to add details about another school? Yes No Additional School Details:Use the space below to provide school name, location, graduation date or expected graduation date (if applicable), and your major course of study (if applicable). Please list any licenses, certifications, awards, or trainings you currently hold:Have you had any experience in the Armed Forces of the United States or in a State National Guard?* Yes No Branch: Current rank or rank at discharge: Date of Discharge: MM slash DD slash YYYY Are you currently in the reserves?* Yes No Date obligation ends: MM slash DD slash YYYY EMPLOYMENT HISTORYPlease use the Employer spaces below or upload your resume to provide at least 3 years of employment history. Have you ever been terminated or asked to resign from any job, or involuntarily discharged from a position?* Yes No Details:* Upload Resume:Max. file size: 10 MB.Employer Name (1): Location: Employed From: MM slash DD slash YYYY Employed To: MM slash DD slash YYYY Supervisor Name: First Last Reason for Separation:Employer Name (2): Location: Employed From: MM slash DD slash YYYY Employed To: MM slash DD slash YYYY Supervisor Name: First Last Reason for Separation:Employer Name (3): Location: Employed From: MM slash DD slash YYYY Employed To: MM slash DD slash YYYY Supervisor Name: First Last Reason for Separation:Any additional experience, training, or qualifications:APPLICANT CERTIFICATION AND AT-WILL STATEMENTI certify that the facts contained in this application are true, accurate, and complete to the best of my knowledge and understand that, if employed, falsified statements or omitted material facts on this application may result in my disqualification from consideration for employment, or termination from employment if I have already been hired. If offered employment, I understand that the offer may be conditional upon verification of information I provide, as well as other information obtained by the company. In applying for employment, I understand that the company may make a thorough investigation of my entire work and personal history (including reference checks, criminal background checks, and MVR checks), and may verify all data given in my application for employment, related papers, or oral interviews. I authorize such investigation and the giving and receiving of any information requested by the company, and I release from liability any personal giving or receiving of such information. I understand that falsification of data given or any derogatory information discovered as a result of this investigation may prevent my being hired, or if hired, may subject me to immediate dismissal, if the company considers such information to be an impediment to employment. Additionally, I understand that no employment offer is being created at this time. No employee has a contract of employment with this company unless it is in writing and signed by an officer of the company. I understand that if I am employed, my employment and compensation is terminable at-will, is for no definite period, and my employment and compensation may be terminated by the company at any time and for any reason whatsoever, with or without good cause at the option of either the company or myself.I agree:* Yes