Southern Cable & Utilities Group, LLC
A Cable Placement Company
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APPLICATION

Employment Application

Personal Information
First Name: *
Last Name: *
Address 1: *
Address 2:
City: *
State: *
Zip: *
 Email:  
Home Phone: *
Mobile Phone:
Social Security No: *

Employment History
Employer 1:
Position 1:
Reason for Leaving 1:
Employer 2:
Position 2:
Reason for Leaving 2:
Employer 3:
Position 3:
Reason for Leaving 3:

Education History
High School:
Graduated:
College:
Degree Completed:
Trade School:
Course Completed:

Related Experience
Special Training:
Special Skills:

References
Reference 1:
Reference 2:
Reference 3:

Additional Information
Comments:
  By checking this box I give Southern Cable & Utilities Group, LLC authorization to perform an employment and background check prior to an employment offer.
Security Code: *  
By clicking the Submit button, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information that may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

i also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specialized period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

I understand that the company may require a pre-employment drug screening, and has the right to drug test at random or for cause, and that any refusal to submit to a drug test will result in immediate termination.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.
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