Are you over the age of twenty-one?  If you are not, hire is subject to verification that you are of minimum legal age
Do you have a valid driver's license?
Do you have a commercial driver's license?
Job Status Applying for
Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses.  If so list them and if not then please place none in this box.
Elementary School
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Are there any other experiences, skills, or qualifications which you feel would especially fit you for work with our business
Reference 1
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Lineman work is very physical.  To peform this work you will have to demonstrate several physical abilities essential to Lineman work.  These physical abilities are grip strength, upper and lower body muscular strength, muscular endurance, and aerobic capacity.  The abilty to lift items of 112 lbs to a hight of 24 inches, lifting items weighing up to 74 lbs ovehead and climbing poles is essential to our work.  By checking this box you are attesting that you physically and otherwise able to perform the duties of the job of which you are applying.
The facts set forth above in my application for employment are true and complete.  I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal.  You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice.  I also understand that this application form will be maintained in the active files for one year only unless renewed