Meisner Electric, Inc.

Meisner Electric Inc. does not discriminate in the hiring or employment practices on the basis of age, race, religion, color, national origin, sex, marital status, citizenship status, handicap, disability, veteran status, or any other protected status in accordance with the requirements of all federal, state and local laws. Submission of this page is encrypted for your protection.

Personal Information:
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*First Name:

*Last Name:

Present Address:

Street:

City:

State:

Zip:

*Home Phone: (area)xxx-xxxx

*Email Address:

Employment Desired:
If from current openings, list title here.

Licensed Journeyman
Mechanic
Apprentice

Office
Helper

Work History:
List your most recent job and complete this section in full

Name of Employer:

From:

To:

Address:

Title:

Salary:

Phone:

Project Name(s):

Nature of duties:

Supervisor's Name:

Reason for Leaving:

Technical Skills: List any relevant experience with equipment, machinery, computer hardware, software, office equipment, etc.

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Will you follow the safety rules and work policies of this company?

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Are you willing to travel up to 30 miles one way to an assigned job site?

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Will you take a pre-employment drug test at the company's expense?

Yes No

Today's Date (YYYY-MM-DD):

2009-01-06

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What is this?

Please note this mini-application is part of our pre-screening process. If you are considered for employment, you will be required to complete our regular application in full and any additional appropriate paperwork.