Job Application Form | Chariton Valley Electric Cooperative, Inc

Personal Information

Full legal name

Mailing address

Phone number

Email address

Position Information

Position applying for

Date of application

Desired start date

Employment History

List your most recent employer first. Leave this section blank if you have no previous employment.

Previous Employer 1

Employer name

Employer address

Employer phone number

Job title

Start date

End date

I currently work here

Main duties and responsibilities

Reason for leaving

Previous Employer 2

Employer name

Employer address

Employer phone number

Job title

Start date

End date

I currently work here

Main duties and responsibilities

Reason for leaving

Previous Employer 3

Employer name

Employer address

Employer phone number

Job title

Start date

End date

I currently work here

Main duties and responsibilities

Reason for leaving

Education and Qualifications

High school or college attended

Graduation date or current enrollment

Relevant certifications or licenses

Job-related training and skills

References

Provide up to three professional references.

Reference 1

Reference name

Job title of reference

Phone number

Email address

May we contact this reference?

Yes

No

Reference 2

Reference name

Job title of reference

Phone number

Email address

May we contact this reference?

Yes

No

Reference 3

Reference name

Job title of reference

Phone number

Email address

May we contact this reference?

Yes

No

Additional Questions

Describe any additional experience or skills relevant to this position.

Are you legally authorized to work in the United States?

Yes

No

Describe how you meet the required qualifications listed in the job posting.

Are you related to any employee and or director?

Yes

No

If yes, please explain

Certification and Signature

I certify that the information provided in this application is true and complete to the best of my knowledge.

Applicant signature (type your full legal name)

Date signed