Employment Application

General Information

Name*
Mailing Address*
Are you under the age of 18?*
Are you related by blood or marriage to any of the following persons: an employee of Gascosage Electric Cooperative, a member of the Gascosage Electric Board of Directors, or the Manager of Gascosage Electric Cooperative?*
Are you presently legally authorized to work in the U.S. on a full time basis? You will be required as a part of the application process to provide any employment eligibility verification mandated by the Federal Government.*
Are you willing to travel as part of this job?*
Have you ever been employed by Gascosage Electric?*
Have you ever been convicted of (or plea bargained to) a misdemeanor or felony?

Education/Training History

Do you have a high school diploma or a general education development (GED) certificate?
For each school, please include: Institution Name and Location, Dates attended, Major/minor areas of study (if applicable), Degree awarded, Grade Point Average and Year degree was received.

License/Registration Certificate

Include Description, State, Number, Expiration

Specialized Skills and Knowledge

Computer Skills
Office Skills
Accounting
List skills or knowledge that show your ability to perform the job for which you are applying.

Military Experience

References

Lis 3 current references who are familiar with your work-related abilities and background. Do not list relatives.
Name
Address
Name
Address
Name
Address
Name
Address
Name
Address

Accommodation Information

IN SUPPORT OF THE AMERICANS WITH DISABILITIES ACT, SPECIAL ARRANGEMENTS MAY BE MADE FOR CERTAIN DUTIES OF CERTAIN POSITIONS IN ORDER TO ACCOMMODATE A PHYSICAL OR MENTAL IMPAIRMENT OR DISABILITY. YOU ARE NOT REQUIRED TO DISCLOSE SUCH INFORMATION THAT YOU BELIEVE WILL NOT INTERFERE WITH YOUR CAPABILITY TO DO THE JOB. HOWEVER, IF YOU WANT THE COOPERATIVE TO CONSIDER SPECIAL ARRANGEMENTS TO ACCOMMODATE A PHYSICAL OR MENTAL IMPAIRMENT DURING THE SELECTION PROCESS OR CONCERNING THE POSITION FOR WHICH YOU HAVE APPLIED, YOU NEED TO IDENTIFY THE DISABILITY AND THE REQUESTED ACCOMMODATION BELOW.

Work Requirements

MM slash DD slash YYYY
Are you available to work
List job-related training courses by title and year. List honors, awards, volunteer work, and special accomplishments. (publications, memberships in professional/honor societies, leadership activities, public speaking, performance awards, etc.)

Previous Employment

May we inquire of current employer?
May we inquire of current employer?
May we inquire of current employer?
Max. file size: 10 GB.

Applicant Authorization

PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH, THEN SIGN AND DATE BELOW.*

Affirmative - Completion is voluntary

GASCOSAGE ELECTRIC COOPERATIVE IS REQUIRED TO PROVIDE STATISTICAL REPORTS TO GOVERNMENTAL AGENCIES ANALYZING AND MONITORING AFFIRMATIVE ACTION EFFORTS. THE INFORMATION REQUESTED BELOW WILL BE USED FOR THE COMPILATION OF STATISTICAL REPORTS AND RECORD KEEPING PURPOSES, AND NO INFORMATION PROVIDED WILL BE USED IN AN UNLAWFUL MANNER. THE INFORMATION WILL NOT BE KEPT WITH THE APPLICATION OR PERSONNEL FILE AND WILL IN NO WAY AFFECT THE HIRING DECISION.
Race/Ethnicity
Sex
Disable Data
Veteran Data
Veteran
Referral Source