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Employment Application

Full Name: *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Phone: *

Email Address:

Desired Salary:

Date Available:

Position Applied for:

Are you a citizen of the United States?

YESNO

If no, are you authorized to work in the U.S.?

YESNO

Have you ever worked for this company?

YESNO

If yes, when?

Have you ever been convicted of a felony?

YESNO

If yes, explain:

High School:

Street Address

City

State/Province

ZIP / Postal Code

From:

To:

Did you graduate?

YESNO

Diploma:

College:

Street Address

City

State/Province

ZIP / Postal Code

From:

To:

Did you graduate?

YESNO

Degree:

Other Education:

Street Address

City

State/Province

ZIP / Postal Code

From:

To:

Did you graduate?

YESNO

Degree:

Please list three professional referencesProfessional Reference 1:

Relationship:

Company:

Phone:

Address:

Professional Reference 2:

Relationship:

Company:

Phone:

Address:

Professional Reference 3:

Relationship:

Company:

Phone:

Address:

Certifications, Licenses or Other Training

Previous Employment:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

YESNO

Previous Employment:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

YESNO

Previous Employment:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

YESNO

Please list any additional skills including specialized training or certifications any electronic or mechanical equipment that you are qualified to operate or repair:

Military Service:

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature: *

Equal Employment Opportunity: The Gas Board of The City of Boaz is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, gender, age or disability.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature *

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Optional Resume Attachment

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Quick Contact Numbers

Gas Board Office:
(256) 593-6764
Daytime or Emergency:
(256) 593-6764
Nights, Weekends, or Holidays:
(256) 593-6812
Alabama One Call:
(800) 292-8525 or 811

Connect With Us

Links

Alabama Natural Gas Association
Alabama Pipeline Awareness Cooperative Training
American Gas Association
American Public Gas Association
Smell Gas Act Fast

Call Before You Dig

Call Before You Dig

Paying Your Bill

We accept payments via mail, office, online, telephone, and night depository which is available after hours. Credit and debit cards are accepted. Over the … Learn More

Office Address

138 North Main St
Boaz, AL 35957
7:30 am to 4:30 pm, Mon - Fri
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Copyright © 2023 Boaz Gas Board · All Rights Reserved · PO Box 594 Boaz, AL 35957