Wabash Utilities Inc. - Employment Application

Is the license valid?

Yes
No

If no, please explain:

Has your license ever been revoked?

Yes
No

If yes, please explain:

How did you find out about this company?

Are you employed now?

Yes
No

If so, may we contact your current employer?

Yes
No

Do you have any objection to working overtime?

Yes
No

Can you work overtime without prior notice?

Yes
No

Can you work Saturday?

Yes
No

Can you work Sunday?

Yes
No

Are you willing to travel?

Yes
No

Do you have any relatives currently working for WUI?

Yes
No

Have you ever been employed with us before?

Yes
No

Please check the appropriate dirt excavation equipment that you have operated:

Dump Truck
Forklift
Skidloader
Backhoe
Tractor
Excavator
Bore Machine
Trencher

Please list other dirt excavation equipment you have operated:

Where and for whom did you operate this equipment?

Do you have formal training related to excavation work?

Yes
No

If so, please explain:

Please check the appropriate forestry equipment that you have operated:

Bucket Truck
Chipper
Chainsaw
Skytrim
ASV/Fecon
Stumpgrinder
Bucket/log Skidder
Excavator/Grinder

Please list other forestry equipment that you have operated:

Do you have formal training related to utility line clearance?

Yes
No

If so please explain:

List work performed and equipment operated:

Have you ever been convicted of a felony?

Yes
No

If yes, please explain

Have you ever been convicted of a misdemeanor?

Yes
No

If yes, please explain

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

Application for Employment

Education

Elem/Jr/ High

High School

College

Tech. Training

Other

Employment Record

Dates Employed

Dates Employed

Dates Employed

Personal References