Employment

Date *

Contact Info

First *

MI *

Last *

Address *

City *

State *

Zip Code *

Phone Number *

Email *

Job Type

Position Applying For…

Date available to begin…

Specific Project Applying For…

Salary or Hourly Rate Expected…

Additional Information

Have you previously applied for work with us or have you been employed by us?

Yes

No

If yes, please explain…

Referral Source…

Are you able to perform the essential functions of the job for which you are applying?

Yes

Yes, with reasonable accommodations,

No

If “Yes, with reasonable accommodations”, please identify potential accommodations to your limitation(s).

Bates Utility Company Inc. is proud to be an equal opportunity and affirmative action employer regardless of race, color, gender, age, sexual orientation, gender identity, religious beliefs, marital status, genetic information, national origin, disability or protected veteran status.

Education

Grade School

School Name

City & State

Number of Years Attended

Degree or Grade

Area of Specialty

High School

School Name

City & State

Number of Years Attended

Degree or Grade

Area of Specialty

College or University

School Name

City & State

Number of Years Attended

Degree or Grade

Area of Specialty

Graduate School

School Name

City & State

Number of Years Attended

Degree or Grade

Area of Specialty

Trade, Business, or Other

School Name

City & State

Number of Years Attended

Degree or Grade

Area of Specialty

Special Skills (list)

RECORD OF PREVIOUS EMPLOYMENT

(Detailed explanation may be attached to indicate any special employment experience)

Past Employer 1

Past Employer Name, Address, Phone Number

Department(s) Worked

Supervisor’s Name

Position(s) Held

Employed From-To

Rate of Pay

Reason For Leaving

Add another past employment?

Yes

Past Employer 2

Past Employer Name, Address, Phone Number

Department(s) Worked

Supervisor’s Name

Position(s) Held

Employed From-To

Rate of Pay

Reason For Leaving

Add another past employment?

Yes

Past Employer 3

Past Employer Name, Address, Phone Number

Department(s) Worked

Supervisor’s Name

Position(s) Held

Employed From-To

Rate of Pay

Reason For Leaving

Add another past employment?

Yes

Past Employer 4

Past Employer Name, Address, Phone Number

Department(s) Worked

Supervisor’s Name

Position(s) Held

Employed From-To

Rate of Pay

Reason For Leaving

Add another past employment?

Yes

Past Employer 5

Past Employer Name, Address, Phone Number

Department(s) Worked

Supervisor’s Name

Position(s) Held

Employed From-To

Rate of Pay

Reason For Leaving

Additional Comments About Yourself

Bates Utility Company Inc. is proud to be an equal opportunity and affirmative action employer regardless of race, color, gender, age, sexual orientation, gender identity, religious beliefs, marital status, genetic information, national origin, disability or protected veteran status.

If employed, I agree to abide by all the rules and policies of the Company and will obey the orders and instructions of my supervisor. I will use and wear all safety appliances furnished by the Company and will work in a safe manner observing all Company safety rules, not exposing myself or other workers to unnecessary dangers.
If employed, I understand that the use, possession or being under the influence of drugs, alcohol or any controlled substances, other than that prescribed by a physician, is strictly prohibited on Company premises and during working time.
I understand that employment will be on a at will basis and may be terminated at any time by either party with or without notice.
I authorize this Company to seek information about me from various sources and I agree to hold the Company harmless from any and all claims arising from such requests for information.
I agree that all former employers or any other persons may furnish this Company and subsidiaries with all information regarding their record of my service, character and reason for leaving. I hereby release such former employers and persons from all liability for providing such information.
I understand that any false, incomplete, omitted or misleading information on this application may result in the rejection of this application or, if hired, the termination of my employment.
I understand that any unanswered questions on this application may cause this application to be rejected.
I understand employment is contingent on a negative drug test. If hired, refusal to take a drug test will be grounds for dismissal.

Signature *

Date *

THIS APPLICATION WILL BE RETAINED IN OUR ACTIVE FILES FOR ONE (1) YEAR ONLY.

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Employment

We are an inclusive utility contractor that has thrived for over 40 years, largely due to our passionate employees.

Union Laborers and Operators are at the core of our company; working alongside our Project Managers, Engineers, and Owners to create a strong and intelligent workforce.

Employment Application

Contact Info

Job Type

Additional Information

Education

Grade School

High School

College or University

Graduate School

Trade, Business, or Other

RECORD OF PREVIOUS EMPLOYMENT

(Detailed explanation may be attached to indicate any special employment experience)

Past Employer 1

Past Employer 2

Past Employer 3

Past Employer 4

Past Employer 5

THIS APPLICATION WILL BE RETAINED IN OUR ACTIVE FILES FOR ONE (1) YEAR ONLY.