Electrical Installation Technician

Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code

Email
Primary Phone*
Secondary Phone
Best time to contact you

Have you ever completed and application with us before?*
- Yes
- No
Approximate date of previous application
Have you ever been employed with us before?*
- Yes
- No
Approximate months/ years of previous employment
Do any of your friends or relatives work for Concord Road Equipment?*
- Yes
- No
Give name(s) and relationship*

Other Training (specify)
Would you like to upload a resume?
- Yes
- No
Resume*
Max. file size: 2 MB.

Employment History

Please provide information about your previous ten (10) years of employment beginning with the most recent. If applicable, please indicate periods of unemployment, service in the armed forces, or volunteer activities.
Description of Most Recent Employment*
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information
Description of Previous Employment (1)
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information
Description of Previous Employment (2)
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information
Description of Previous Employment (3)
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information
Description of Previous Employment (4)
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information
Description of Previous Employment (5)
Be sure to include the name of employer, address, supervisor, phone number, job title, dates of employment, major duties, final salary, reason for leaving, and any other pertinent information

References

List three professional / work references from positions held within the last ten years.
Reference 1*
Please include reference Name, Affiliation, Company, Title / Position, Phone, Email, Years Known, Etc.
Reference 2*
Please include reference Name, Affiliation, Company, Title / Position, Phone, Email, Years Known, Etc.
Reference 3*
Please include reference Name, Affiliation, Company, Title / Position, Phone, Email, Years Known, Etc.

Additional Information

Use this section to describe any additional specialized skills and or abilities that would aid you in meeting the qualifications for the position that you would like to add for consideration.
Additional Job-Relevant Information
Tools, Equipment, Machinery, Computer Hardware / Software, etc.

Have you been convicted of a crime significant to the position for which you are applying?*
- Yes
- No
Have you been convicted of a felony of any nature and/or misdemeanor of violence or moral depravity?*
- Yes
- No
Please Explain
A conviction record will not necessarily bar employment. Factors such as your age at the time of the crime, seriousness of the crime, and nature of the crime in relation to the position are taken into consideration.

Applicant's Authorization and Agreement

I certify that the facts provided on this application or on any accompanying resume are true and complete to the best of my knowledge. I understand that any omission, misrepresentation or falsification of provided information is sufficient cause for rejection of my application or termination of my employment no matter when discovered by the Company.

I understand that any offer of employment is conditional upon proof of legal authorization to work in the United States as required by the Immigration Reform and Control Act of 1986.

I understand that Concord Road Equipment is a drug free workplace and that upon any offer of employment I agree to submit to a pre-employment drug screen. I understand that the results will unconditionally determine my eligibility for employment. If employed, I also agree to submit to a medical examination, alcohol test or drug screen at any time deemed appropriate by the Company and as permitted by law. I consent to the results of such examinations or tests to be disclosed to the Company by the examining physician(s). I understand that my employment or continued employment, to the extent permitted by law, is contingent upon results disclosed to the Company from any medical examination, alcohol test or drug screen.

I understand that any employment is contingent upon the review of my personal background information including but not limited to verification of education, investigation of present and past employment, and review of any existing criminal records. I authorize my former employers and references to disclose information about my former employment, character, and general reputation to Concord Road Equipment without prior notice of such disclosure. In addition, I release the Company, any former employers and all references listed above from any and all claims, demands, or liabilities that develop out of such investigation or disclosure.

I consent to the Company obtaining a Driver’s Abstract Report from the state in which I have held a standard or commercial driver’s license in the past five years if driving is an essential function of the position. I understand that I may be considered ineligible for employment if my driving record does not meet the standards of Concord Road Equipment and/or its insurer. I release Concord Road Equipment and its representatives from liability for seeking such information and all sources for furnishing such information.

I understand that completing this form does not indicate that a position is available and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. I further understand that the Company retains the right to revise its policies or procedures, in whole or in part, at any time. By signing below, I certify that I have read and agree with the above statements.
Applicant Signature

Truck Equipment Division

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POSITION SUMMARY

ILLUSTRATED RESPONSIBILITIES

WORK ENVIRONMENT

KNOWLEDGE, SKILLS AND ABILITIES

MINIMUM EMPLOYMENT QUALIFICATIONS

Employment Application Form

Step 1 of 15

Employment History

References

Additional Information

Applicant's Authorization and Agreement