First Name*
Last Name*
Email Address*
Phone*
Are you 18 years of age or older?*
-- No answer -- yes no
If referred by a friend, who? (full name)*
Do you currently maintain a valid PA Driver's License?*
-- No answer -- yes no
When are you available to start work?*
Have you ever filed an application with us before?*
-- No answer -- yes no
If yes, when?
Are you currently employed?*
-- No answer -- yes no
Are you currently on "lay off" status and subject to recall?
-- No answer -- yes no
Can you travel if the job requires it?*
-- No answer -- yes no
Are you free from a criminal conviction within the last ten (10) years? DISCLAIMER: Candidate should not provide information about a criminal conviction that has been expunged or sealed pursuant to law. The law provides an exception for federal laws that require consideration of an applicant's criminal history for purposes of employment.*
-- No answer -- yes no
If no, please explain
Are you a U.S. citizen, or are you otherwise authorized to work in the U.S. without restriction?*
-- No answer -- yes no
Have you ever been terminated or asked to resign from any position of employment?*
-- No answer -- yes no
If selected for employment, are you willing to participate in a pre-employment drug screening test?*
-- No answer -- yes no
What are your salary expectations for this position? (either per hour or per year)
Please check each type of schooling you attended:*
High School Trade/Technical School College/University
Please check each type of schooling you graduated from:
High School Trade/Technical School College/University
List school/major course of study
List school/major course of study
List school/major course of study
Do you have any other schooling or training not listed?
-- No answer -- yes no
If yes, please list here:
Please Check Any Licenses or Certifications You Have
Apprentice Electrician License Journeyman Electrician License Master Electrician License Registered Professional Engineer OSHA-10 Certification OSHA-30 Certification CPR/First Aide
Please List Any Licenses or Certifications Not Mentioned
What Computer-Related Experience Do You Have?
AutoCad BlueBeam Estimation Software Microsoft (Excel, Work, Outlook) Other
Please list other computer experience not listed
Reference 1: Please list a person you have worked with who can attest to your On-The-Job experience and performance. (list name/relationship)
Reference 1 phone number
Reference 2: Please list a person you have worked with who can attest to your On-The-Job experience and performance. (list name/relationship)*
Reference 2 phone number
Reference 3: Please list a person you have worked with who can attest to your On-The-Job experience and performance. (list name,/relationship)
Reference 3 phone number
REQUEST FOR AN APPLICATION FOR EMPLOYMENT STATEMENT PART A (TYPE NAME FOR UNDERSTANDING)
This is a request for an Application for Employment at Merit Electrical Group, Inc., (the “Company”). I understand, and agree, that the Application will be given to me and will be considered only on these conditions:
(1) If requested, I will give a resume, provide any other requested relevant information, and take any work-related tests which are not prohibited by law. If I choose not to do any of these things, the Company is free from any need to further process this Request and I hereby release the Company from all liability of any kind because of its non-processing of this Request.
(2) If hired, my hiring will be substantially based on my Application and the other information I supplied prior to my hiring. All such information is important and necessary to the Company’s decision whether or not to hire me. Accordingly, any falsehoods in the information supplied by me, the withholding of any requested information, or any failure of good faith concerning the facts, preparation, signing or handling of the Application or other information which I give to the Company may, if I am hired, be full justification for my discharge from my employment, regardless of when, after my hiring, the Company learns of the facts, or how long a time period has passed between my hiring and the discharge. Applications must be completed in their entirety, including the employment history. Applicants must not put any information on the application which is not requested.
(3) The Company, its employees, and others dealing with the Company, are very interested in the Company providing a safe and drug-free work-place. As a result, both before hire and at any time during my employment if I am hired, I will submit to tests requested by the Company which relate to the use of alcohol, unlawful drugs or controlled substances.*
REQUEST FOR AN APPLICATION FOR EMPLOYMENT STATEMENT PART C (TYPE NAME FOR UNDERSTANDING)
(8) I understand and agree that if I am hired, my employment will be “at-will.” I understand that “at will” employment means that, for any reason or without any reason, and at any time, either I or the Company can discontinue my employment without either of us having or giving any reason for the discontinuation of my employment with the Company.
(9) It is the policy of the Company to be an equal opportunity, non-discriminatory employer. We do not discriminate on the basis of race, sex, color, age, religion, national origin, non-job related disability, marital status, union affiliation (if any), or any other lawfully protected status. Accordingly, we make every effort to abide by all federal, state and local laws governing all aspects of the employment relationship with our employees, including respecting the right of our employees under Section 7 of the NLRA. Should any of our employment policies or practices be in conflict with any such federal, state or local laws, our policies and practices will be considered amended or revised to the extent necessary in order to conform with the law.
I, the applicant, certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.*
RELEASE AUTHORIZATION (LIST FIRST, MIDDLE, LAST NAME)
In connection with my application for employment, understand that a consumer report or an investigative consumer report may be requested that will include information as to my character, work habits, performance, and experience, along with reasons for terminations of past employment. I understand that as directed by Merit Electrical Group policy and consistent with the job described, you may be requesting information from public and private sources about my education, credentials, credit and references. I am willing to submit to drug testing to detect the use of illegal drugs to and during my employment.
I hereby authorize, without reservation, any law enforcement agency, institution, information service bureau, school, employer or reference contacted by Merit Electrical Group, Inc.
I hereby release Merit Electrical Group, Inc. and agents, and all persons, agencies and entities providing information or reports about me from any and all liability arising out of the requests for or release of any of the above mentioned information or reports.*
Please list any other names you have used
Today's Date*
Invitation for Job Applicants to Self-Identify as a U.S. Veteran
A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
a person who was discharged or released from active duty because of a service-connected disability.
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Voluntary Self-Identification of Disability
Voluntary Self-Identification of Disability Form CC-305
OMB Control Number 1250-0005
Expires 04/30/2026
Why are you being asked to complete this form?
How do you know if you have a disability?