Personal Information

    Are you a U.S. citizen?
    Are you authorized to work in the U.S.?






    Add any high schools, colleges, and trade schools.
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    Add any past work experience.
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    Add your personal references.
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    Accredited College Coursework
    Please check all that apply
    Please list any other skill that may be relevant to this job
    Driver's license?
    Please list DL number, issuing state and expiration date
    Type of Driver's Licence
    Please check all that apply
    Have you had any accidents during the past three years?
    How many accidents have you had during the past three years?
    Have you had any moving violations during the past three years?
    How many moving violations have you had during the past three years?
    Have been convicted of a crime?
    Have you ever been convicted of a crime which is substantially related to the functions or qualifications of the job for which you are applying?
    If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.
    Have you ever been in the armed forces?
    Are you now a member of the national guard?
    What was your specialty, the date entered, and the you were discharge Date:
    Did you complete this application yourself?
    After reviewing the attached job description, please indicate if you are able to perform the functions of the job for which you have applied?
    Do you have any reason to believe that you would have difficulty meeting this company's work schedule?



    By submitting and signing with a digital signature below, I am acknowledging that I have read, and agree to the each of the statements below. Once your application is accepted, you will be required to sign a background check disclosure.

    In exchange for the consideration of my job application by Joe Wheeler EMC, I agree to the following:

    I understand that employment with Joe Wheeler EMC is subject to a pre-employment drug and/or alcohol screening and that a positive result could result in the loss of my pending/possible employment.

    I understand that employment with Joe Wheeler EMC is subject to a post-offer physical examination in relation to the job in which I am applying.

    I understand that Joe Wheeler EMC has an employee anti-nepotism policy. I attest that I will review a list of current employees, when provided, to ensure that I am not a relative of an active employee of the cooperative or its board of directors. I understand that by falsifying this information, my opportunity for employment will be void.

    I further understand that my employment with Joe Wheeler EMC shall be probationary for a period of six months and further that at any time during the probationary period or thereafter, my employment relationship with the Company is terminable at will for any reason by either party.

    I understand that Joe Wheeler EMC has a random drug screening program in which I must participate.

    I understand that neither this application nor any subsequent employment of Joe Wheeler EMC which may result, constitutes a contract for employment for any definite duration and that my employment may be terminated either by me or by Joe Wheeler EMC at any time and for any reason except as otherwise governed by law.

    I authorize investigation of all statements contained in this application.

    I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.

    I hereby give the Company permission to contact schools, all previous employers (unless otherwise indicated), references and others and hereby release the Company from any liability as a result of such contact.

    I understand the Company may perform a background check on me. (completion of a separate disclosure/consent form and signature of the same is required).

    Digital Signature