Caye Electric Company

24-Hour Service:
All your electrical needs are only a phone call away.

We Work for You:
We're proud of our reputation for superior customer service that's why we'll never try to sell you something you don't need. Learn more about us.

Free Estimates:
Just give us a call to set up an appointment or click here to use our convenient, on-line form.

Please fill out the service request below and we will be in touch soon.

Your Contact Information:

Name:

Address:

City, State Zip:

Home Phone:

Mobile Phone:

Email Address:

If employed, can you show proof of U.S. citizenship?

Yes

Are you 18 or over?

Yes

Are you presently employed?

Yes

If Yes, may we contact your present employer?

Yes

If employed, will you be able to travel and work on projects throughout the state of Kentucky?

Yes

Do you hold a current Kentucky Drivers License?

Yes

What is your Drivers License #?

Education Record:

High School:

Address:

Dates Attended:

Degrees or Diplomas:

College / University:

Address:

Dates Attended:

Degrees or Diplomas:

Trade or Technical Training:

Address:

Dates Attended:

Degrees or Diplomas:

Military Service:

Branch of Service:

Dates of Service:

Duties / Special Training:

Employment History:

Begin with most Recent Employer

Employer:

Dates of Employment:

Address:

City, State Zip:

Phone:

Beginning Salary:

Ending Salary:

Title / Duties:

Manager's Name:

Why did you leave:

Employer:

Dates of Employment:

Address:

City, State Zip:

Phone:

Beginning Salary:

Ending Salary:

Title / Duties:

Manager's Name:

Why did you leave:

Personal Data:

Have you been convicted of a crime (other than traffic violations) or been imprisoned during the last seven years? A conviction will not necessarily bar you from employment.

Yes

If yes, explian.

Names of friends or relatives that are employed by Caye Electric Company Inc.. if any.

References:

List two professional references who are familiar with the quality of your work, have worked directly with you, ad have known you at least two years.

Reference Name:

Work Phone:

Address:

City, State Zip:

Relationship:

Reference Name:

Work Phone:

Address:

City, State Zip:

Relationship:

"Required"

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

If you decide to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.
Typing your full name in the following space constitutes your legal signature:

Signature:

Today's Date: