Page 1 Page 2 Page 3 Page 4 Phone First Name * Last Name * Street Address City State ZIP E-mail Address * Phone Social Security Number (SSN): Referred by: Employment Desired: Position Desired * Date You Can Start: Salary Desired: Are you currently employed? Yes No If so, may we contact your employer? Yes No Have you applied to Bayou in the past? If so, when? What is the current state of your Texas license? Journeyman Apprentice Electrician Education: Name / Location of High School: Years Attended: Degree / Diploma Received? No Yes Name Location of College: Years Attended: Degree / Diploma Received? No Yes Name / Location of Vocation or Trade School: Years Attended: Degree / Diploma Received? No Yes Other Training or Education (including Military Experience): Experience: Previous Employer Name & Location: Years of Employment, Position & Reason for Leaving: Previous Employer Name & Location: Years of Employment, Position & Reason for Leaving: Previous Employer Name & Location: Years of Employment, Position & Reason for Leaving: References: REFERENCE 1: Name, Address, Phone Number: REFERENCE 2: Name, Address, Phone Number: REFERENCE 3: Name, Address, Phone Number: REFERENCE 4: Name, Address, Phone Number:
