TESSCO - Total Electrical Service and Supply Company

The company you can depend on for all of your electrical service needs.

Prospective applicants are encouraged to complete all elements of the application, for quality assurance. If a field is not applicable, please indicate so by putting "NA".

In compliance with State and Federal equal opportunity laws, qualified applicants are considered for all positions, without regard to race, color, religion, sex, national origin, age or marital status.

Date

Your Last Name
Your First Name, Middle Initial
Street Address
City
State
Zip Code
Home Phone
Social Security Number
Business Phone
E-mail Address
Type of Work	Full Time Temporary Temp to Hire
Position Desired
Are you 21 years of age or older?	Yes No
Are you a United States citizen?	Yes No
Are you willing to relocate?	Yes No
Referred by:
Date you can start:

Are you willing to take a urinalysis
test before and during work hours?

Yes No

Have you been convicted of a criminal offense other than a traffic ticket?

Yes No

If the answer to the previous question is yes, list the date.

Please list the place the offense occurred.

Nature of the offense:

Most Recent Employment

Employer
Address
City
State
Zip Code
Job Title
Employed from	to
Reason for Leaving
May we contact this employer?	Yes No

Personal Reference

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Address
City
State
Zip Code
Occupation
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Comments

Please list any degrees, diplomas, academic achievements or memberships in any professional organizations that are related to the position for which you have applied

Please list any previous experience you may have that is related to the position for which you have applied.