Employment Questionnaire

Date

Please Provide the Following Contact Information:

Name

Address

Home Phone

Cell Phone

Email Address

Craft/Classification Apprentice Electrician Electrical Technician Instrument Fitter Instrument Technician Lineman HVAC Others

Work Type Preferred Construction Work Project Work Maintenance Work

Number of years experience

Do You Have Formal Training in Your Related Craft? Yes No Others

If Yes, School Name

Did You Graduate? Yes No Graduation Date

Do You Have NCCER Certification For Your Related craft? Yes No

NCCER Level Achieved Written Plus Others

Are You Currently Employed? Yes No

If Yes, With Whom?

Are You a Previous Westgate Employee? Yes No

If Yes, Date Last Employed

Do You Have a Current Twic Card? Yes No

Do You Have a Current Osha Card? Yes No

Do You Have a Current Security Passport? Yes No

Do You Have a Valid Drivers License? Yes No

Are You Willing to Travel? Yes No

If You Have a Resume, Attach Here

Comments

Disclaimer: This form is in no way an employment application.