Careers

Application for Employment

Step 1 of 5

Durbin Electric is an equal opportunity employer. Durbin Electric does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.

Personal Information

Incomplete information could disqualify you from further consideration. Please complete all fields.

Your Name(Required)

First Last

Date(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Email Address(Required)

Enter Email Confirm Email

Home Phone

Mobile Phone

Social Security Number (SSN):(Required)

Education & Employment

High School

Name

Location

Degree Received/Diploma

College or University

Name

Location

Degree Received/Diploma

Trade, Business or Correspondence School

Name

Location

Degree Received/Diploma

Previous Employment History

Include your last three (3) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

Employer #1

From(Required)

To(Required)

Employer Name(Required)

Phone(Required)

Job Title(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Immediate Supervisor(Required)

First Last

Title(Required)

Summarize the nature of work performed and job responsibilities(Required)

Starting Pay(Required)

Ending Pay(Required)

Responsibilities(Required)

Reason for Leaving(Required)

Employer #2

From

Employer Name

Phone

Job Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Immediate Supervisor

First Last

Title

Summarize the nature of work performed and job responsibilities

Starting Pay

Ending Pay

Responsibilities

Reason for Leaving

Employer #3

From

Employer Name

Phone

Job Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Immediate Supervisor

First Last

Title

Summarize the nature of work performed and job responsibilities

Starting Pay

Ending Pay

Responsibilities

Reason for Leaving

Do you have any special skills, experience and/or training that would enchance your ability to perform the position applied for? If yes, explain.(Required)

Military Service

Are you a veteran?(Required)

Yes

Branch:

Rank at Discharge:

From:

To:

Type of Discharge:

If not honorable, please explain:

2851395214

Careers

Application for Employment

Personal Information

Employment Eligibility

Employment Desired

Referral Source

Education & Employment

Previous Employment History

Employer #1

Employer #2

Employer #3

Military Service

References

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