Application for Employment

Section 01 Personal Information Tell us how to contact you.

First name

Last name

Email address

Cell phone

Home phoneOptional

Physical or mailing address

City

State

ZIP code

Section 02 Position and Availability Provide your availability and compensation information.

Job applied for

Employment type

Date available for work

Desired wage or salary

Current employment starting pay

Current employment ending pay

Section 03 Driver Information Complete this section for positions that require driving.

Driver license numberOptional

License classOptional

Driver information is used only when relevant to the position and employment review.

Section 04 Employment Questions Answer each question completely and accurately.

Are you a U.S. citizen, or are you otherwise authorized to work in the U.S. without restriction?

Yes No

If selected for employment, are you willing to submit to a pre-employment drug-screening test?

Yes No

Have you ever been convicted of a felony?

Yes No

Have you ever been involuntarily terminated or asked to resign from a position of employment?

Yes No

Are you related to a current Greenbelt Electric Cooperative employee or board member?

Yes No

Section 05 Education and Training List schools, credentials, and job-related training.

High School or GED

School or institution

Number of years completed

Diploma, degree, or certificate

College or University

School or institution

Number of years completed

Diploma, degree, or certificate

Vocational or Technical

School or institution

Number of years completed

Diploma, degree, or certificate

Skills, certifications, or additional training related to the position

Section 06 Previous Employers List up to three recent or relevant employers.

Employer 1

Previous Employer

Employer name *

Start date

End date

Starting pay

Ending pay

Supervisor name

Supervisor phone

Job duties

Reason for leaving

Section 07 References List three references who are not related to you.

Reference 1

Professional Reference

Name *

Relationship

Phone *

Email Optional

Reference 2

Professional Reference

Name *

Relationship

Phone *

Email Optional

Reference 3

Professional Reference

Name *

Relationship

Phone *

Email Optional

Section 08 Resume and Supporting Documents Add documents that support your application.

Upload your files

Include a resume, cover letter, transcripts, licenses, or certifications.

PDF, DOC, DOCX, TXT, JPG, JPEG, or PNG. Maximum 10 MB per file and five files total.

Choose Files

Section + Previous Employers List up to three recent or relevant employers.

Employer 1 name

Start date

End date

Starting pay

Ending pay

Supervisor name

Supervisor phone

Job duties

Reason for leaving

Employer 2 name

Start date

End date

Starting pay

Ending pay

Supervisor name

Supervisor phone

Job duties

Reason for leaving

Employer 3 name

Start date

End date

Starting pay

Ending pay

Supervisor name

Supervisor phone

Job duties

Reason for leaving

Section + References List three references who are not related to you.

Reference 1 name

Professional relationship

Phone

Email

Reference 2 name

Professional relationship

Phone

Email

Reference 3 name

Professional relationship

Phone

Email

Section + Resume and Supporting Documents Add documents that support your application.

Resume and supporting documentsInclude a resume, cover letter, transcripts, licenses, or certifications. PDF, DOC, DOCX, TXT, JPG, JPEG, and PNG files are accepted.

Section + Applicant Acknowledgement Read each statement carefully before signing.

Applicant acknowledgement

I certify that all information provided in this application is true and complete. I understand that false information or omissions may disqualify me from consideration and may result in dismissal if discovered later. I authorize a thorough investigation of the statements in this application and matters relating to my background and qualifications. This investigation may include employment and education history, consumer or investigative consumer reports, driving records, and criminal history. I authorize persons, schools, current and former employers, consumer reporting agencies, and other organizations to provide relevant information. I release persons and organizations requesting or supplying such information as permitted by law. I understand that I may be required to successfully pass pre-employment or post-employment drug screening as a condition of employment. I understand that this application and any subsequent employment do not create a contract or guarantee employment for a definite period. If employed, employment is at will and may be terminated at any time, with or without cause or notice, subject to applicable law.

Draw your signature

Sign above using a mouse, stylus, or touch screen.

Section 09 Applicant Acknowledgement Read each statement carefully before signing.

I certify that all information provided in this application is true and complete. False information or omissions may disqualify me from consideration or result in dismissal if discovered later.

I authorize an investigation of statements in this application and matters related to my background and qualifications, as permitted by law.

I understand that this application and any subsequent employment do not create a contract or guarantee employment for a definite period.

I have read and agree to the statements above. Checking this box and entering your name constitutes your electronic acknowledgement.

Electronic signature

Signature date