Employment Application Full Name: *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodePhone: *Email Address:Desired Salary:Date Available:Position Applied for:Are you a citizen of the United States?YESNOIf no, are you authorized to work in the U.S.?YESNOHave you ever worked for this company?YESNOIf yes, when?Have you ever been convicted of a felony?YESNOIf yes, explain:High School:Street AddressCityState/ProvinceZIP / Postal CodeFrom:To:Did you graduate?YESNODiploma:College:Street AddressCityState/ProvinceZIP / Postal CodeFrom:To:Did you graduate?YESNODegree:Other Education:Street AddressCityState/ProvinceZIP / Postal CodeFrom:To:Did you graduate?YESNODegree: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 TrainingPrevious 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?YESNOPrevious Employment:Phone:Address:Supervisor:Job Title:Starting SalaryEnding Salary:Responsibilities:From:To:Reason for Leaving:May we contact your previous supervisor for a reference?YESNOPrevious Employment:Phone:Address:Supervisor:Job Title:Starting SalaryEnding Salary:Responsibilities:From:To:Reason for Leaving:May we contact your previous supervisor for a reference?YESNOPlease 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 *Start signing your signature hereYour browser does not support e-Signature field.Optional Resume AttachmentChoose FileNo file chosenDelete uploaded fileSend Message