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Employment Application Step 1 of 4 0% Personal InformationUpload Your ResumeMax. file size: 300 MB.Applicant's Name(Required) First Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Have you lived at this address for at least 5 years?(Required) Yes No Previous Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone(Required)Email(Required) I understand that upon employment, proof of legal right to work in the United States and completion of I-9 form will be requiredAre you eligible to work for any United States employer at this time?(Required) Yes No Have you ever been convicted of a felony?(Required) Yes No Please explain(Required)Do you have a valid driver's license?(Required) Yes No Driver's License Number(Required) Expires (mm/dd/yyyy)(Required) Month Day Year Can you travel if the position requires travel?(Required) Yes No Have you ever worked under or earned degrees under another name?(Required) Yes No Please list other name(Required) First Last Position DesiredPosition You Are Seeking(Required) How did you learn of this positon?(Required) Date You Are Available to Begin Work (mm/dd/yyyy)(Required) Month Day Year Are you able to perform the essential functions of this position?(Required) Yes No What accommodations would make it possible for you to perform this job?(Required)Have you previously been employed by Graham County Electric Cooperative or another electric cooperative?(Required) Yes No Please indicate position, department, and dates(Required) Do you have any relatives employed at Graham County Electric Cooperative?(Required) Yes No Who?(Required) Education & TrainingIndicate Last Level of Education CompletedHigh School 1 2 3 4 College 1 2 3 4 Graduate School 1 2 3 4 EducationClick the + to add a new rowType of EducationName and Location (City, State, County)GPADid you graduate?Major and MinorDegree Earned Add RemoveOccupational or professional certifications and licensesComputer skills (software programs. hardware, operating systems)Other skills or experience that are pertinent to the job applied for Employment HistoryList your last 3 employers with the most recent firstAre you currently employed?(Required) Yes No May we contact your current employer?(Required) Yes No Employer 1Current Employer Dates Employed (mm/yyyy to mm/yyyy) Starting SalaryCurrent SalaryContact's PhoneAddress Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor's Name Supervisor's Job Title Your Job Title Previous Employer Dates Employed (mm/yyyy to mm/yyyy) Starting SalaryEnding SalaryContact's PhoneAddress Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor's Name Supervisor's Job Title Your Job Title Reason for LeavingEmployer 2Previous Employer Dates Employed (mm/yyyy to mm/yyyy) Starting SalaryEnding SalaryContact's PhoneAddress Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor's Name Supervisor's Job Title Your Job Title Reason for LeavingEmployer 3Previous Employer Dates Employed (mm/yyyy to mm/yyyy) Starting SalaryEnding SalaryContact's PhoneAddress Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor's Name Supervisor's Job Title Your Job Title Reason for LeavingProfessional ReferencesReferencesClick the + to add a new row (Please list only references that we may contact at this time)NameTitleCompanyPhone Number Add Remove AffidavitConsent(Required)Non-binding Application and Interview Process: I understand that this application will be reviewed, but nothing in this application or any other documents or in the employment evaluation process shall be construed as either an offer or contract of employment or an obligation on the part of Graham County Electric Cooperative to provide any benefit to me.I hereby declare that my statements on this application and on my resume or documents provided by me to Graham County Electric Cooperative are true and correct to the best of my knowledge. I acknowledge and agree that providing any false information may result in a decision not to hire me, or if hired, may result in the termination of my employment. I also authorize investigation of these statements. This investigation may include employment history; reasons for leaving previous employers, criminal record, credit record, driving record, social security number investigation, and degree/certificate verification. I hereby release Graham County Electric Cooperative from all liability for any damages resulting from the information obtained. This application shall be considered active for a period of time not to exceed 180 days. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Applicant's Electronic Signature (Full Name)(Required) PhoneThis field is for validation purposes and should be left unchanged.
