Work With Rushing

    Date

    Referral Source

    Personal Information

    Rushing Electric is a DRUG-FREE workplace. A pre-employment drug screen WILL be required.

    First Name

    Last Name

    Street Address

    City

    State

    Zip

    Home/Cell Phone

    Email

    Marital Status

    Emergency Contact Name

    Emergency Contact Relation

    Emergency Contact Phone

    Position Applying For

    Can you perform the essential job requirements with or without accommodations?

    Do you have a valid Driver's License?

    Have you filed an application here before?

    If Yes, Give Date

    Have you ever been employed here before?

    If Yes, Give Date

    Are you employed now?

    May we contact your employer?

    On what date would you be available to work?

    Will you work overtime if asked?

    Are you a layoff and subject to recall?

    Are you willing to travel

    Employment History

    Start with your present or most recent employer.

    #1

    Company

    Telephone

    Address

    Employed (month and year)

    Name of Supervisor

    Weekly Pay

    State Job Title and Describe Work

    Reason for Leaving

    #2

    Company

    Telephone

    Address

    Employed (month and year)

    Name of Supervisor

    Weekly Pay

    State Job Title and Describe Work

    Reason for Leaving

    #3

    Company

    Telephone

    Address

    Employed (month and year)

    Name of Supervisor

    Weekly Pay

    State Job Title and Describe Work

    Reason for Leaving

    #4

    Company

    Telephone

    Address

    Employed (month and year)

    Name of Supervisor

    Weekly Pay

    State Job Title and Describe Work

    Reason for Leaving

    Education History

    College Name & Location

    College Years

    Did you Graduate

    High School Name & Location

    High School Years

    Did you Graduate?

    Other School Name & Location

    Other School Years

    Did you Graduate?

    References

    Give the names of three persons not related to you, whom you have known at least one year.

    #1

    Reference 1 Name

    Reference 1 Address

    Reference 1 Business

    Reference 1 Phone

    #2

    Reference 2 Name

    Reference 2 Address

    Reference 2 Business

    Reference 2 Phone

    #3

    Reference 3 Name

    Reference 3 Address

    Reference 3 Business

    Reference 3 Phone

    Legal Disclaimer

    The information provided in this application for employment is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

    The applicant understands and agrees that if employment is offered by Rushing Electric Company, Inc., such employment will be on an “at-will” basis. This means that either the applicant or the Company may terminate the employment relationship at any time, for any reason, with or without cause. The applicant further understands that the “at-will” nature of employment with Rushing Electric Company, Inc. can only be altered by a change in company policy. Additionally, the applicant understands and agrees that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ the applicant in the future.

    The applicant understands that an offer of employment is conditioned upon the applicant’s consent to drug testing.

    I, the applicant, authorize investigation of all statements contained herein, and I also authorize the references listed above to give Rushing Electric Company, Inc. any and all information concerning by previous employment and any pertinent information they may have personal or otherwise, and I release all parties from all liability and any damage that may result from furnishing the same to Rushing Electric Company, Inc.

    I, the applicant, understand that if I accept employment and it is discovered that I have falsified this document or any other document required during the course of my employment, said falsification will be grounds for termination.

    I agree to the above.

    Address

    411 Hwy 80 W
    Garden City, GA  31408

    Phone/ Fax

    Phone: (912) 965-0805
    Fax: (912) 965-0770

    Hours of Operation

    Office Hours:
    M-F 8am-4:30pm