1) Personal Information

2) Applied Position Information

Do you have prior commitments which would effect the hours you are available to work?
 Yes No

If yes, please explain:

Please list any special skills/interests you feel help qualify you for this position:

Have you ever been formally disciplined by a past employer regarding attendance?
 Yes No

If yes, please explain:

Have you ever had any misunderstanding about merchandise or funds?
 Yes No

If yes, please explain:

List all hand tools you have:

Have you ever been employed by Frye Electric, Inc, in the past?
 Yes No

Do you receive compensation from an employer in the construction industry?
 Yes No

Do you intend to continue to receive compensation from an entity within the construction industry?
 Yes No

3) Employment History

Reason for leaving:

Reason for leaving:

Reason for leaving:

4) Personal References

List the name, occupation and phone number of three references who are not related to you and are not previous employers.

5) Medical History

Please list any physical conditions which may limit your ability to perform the job for which you are applying:

Have you had a major illness in the past seven years?
 Yes No

If yes, please explain:

Please identify any accomodations you consider necessary to allow you to perform the job you are seeking:

6) Education

Please list any technical, business or military experience:

Please give names of friends/relatives employed by Frye Electric, Inc. now or in the past:

Frye Electric, Inc is an equal opportuity employer. Frye electric, Inc. extends our hiring opportunities without regard to age, race, sex or religion.

For consideration of your application, this application must be completed and signed. I affirm under penalties for perjury that the information listed above is true and accurate.

Signature:
Date:
Verification: