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Summary
Title:	Utility Lighting Technician
ID:	1444
Location:	Charleston, SC
Department:	Utility

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* First Name:
* Last Name:
Middle Initial:
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Employment Application 2024

EMPLOYMENT APPLICATION

Gregory Electric Company, Inc. is an equal opportunity employer committed to creating a diverse workforce. We consider all applicants without regard to race, religion, color, sex, national origin, sexual orientation, gender identity, disability, or veteran status, among other factors. Gregory Electric Company, Inc. is a Drug Free Workplace.

Applications are filed for available positions or for positions which may arise in the next 30 days.

APPLICATION QUESTIONS

* Are you able to work for any employer in the United States without sponsorship or restrictions?

Yes No

* Are you available to work full-time?

Yes No

* Are you at least 18 years or older? (If no, you may be required to provide authorization to work)

Yes No

Please Indicate your experience in this field of work

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

Last Grade Completed:

High School 9 10 11 12 College 1 2 3 4

High School Attended

Name

Location

Did you Graduate?

Yes No

Subjects Studied/Major

College Attended

Name

Location

Did you Graduate?

Yes No

Subjects Studied/Major

Other

Name

Location

Did you Graduate?

Yes No

Subjects Studied/Major

School 4

Name

Location

Did you Graduate?

Yes No

Subjects Studied/Major

School 5

Name

Location

Did you Graduate?

Yes No

Subjects Studied/Major

EMPLOYMENT HISTORY

Are you currently employed?

Yes No

* Have you ever worked for Gregory Electric company as a contractor and/or employee?

Yes No

If yes, give capacity, date(s) & reason(s) for separation.

List your employment history for the last 3 Years (Starting with Most Recent)

Employer 1

Company Name

Date of Hire

Date of Exit

Position

Company Phone

Supervisor Name

Hourly Pay Rate

Reason for Leaving

Employer 2

Company Name

Date of Hire

Date of Exit

Position

Company Phone

Supervisor Name

Hourly Pay Rate

Reason for Leaving

Employer 3

Company Name

Date of Hire

Date of Exit

Position

Company Phone

Supervisor Name

Hourly Pay Rate

Reason for Leaving

Employer 4

Company Name

Date of Hire

Date of Exit

Position

Company Phone

Supervisor Name

Hourly Pay Rate

Reason for Leaving

Employer 5

Company Name

Date of Hire

Date of Exit

Position

Company Phone

Supervisor Name

Hourly Pay Rate

Reason for Leaving

PERSONAL INFORMATION

* Do you possess the knowledge and ability to perform the essential functions of this position as described in the job description?

Yes No

* Do you have a valid Commercial Driver License?

Yes No

* Do you have a valid driver's license with less than 6 points?

Yes No

* Do you have transportation available to meet our work schedules?

Yes No

* Are you willing and able to travel for work when required?

Yes No

* Are you willing to work outside of the normal work schedule including weekends, holidays and overtime as required in accordance with the position to which you are applying?

Yes No

Note: Several customers will not permit Gregory Electric’s employees on their premises unless those employees pass certain strict background checks. Therefore, the following 2 questions are necessary:

Within the past seven (7) years, have you ever been convicted or pled guilty to a felony or misdemeanor charge of:

* Theft or dishonesty (including but not limited to embezzlement, fraud, and racketeering)

Yes No

* Possession or trafficking of drugs

Yes No

* Physical crimes (such as battery) against persons (including, but not limited to, against minors and incapacitated adults)

Yes No

* Driving under the influence of alcohol

Yes No

If you answered Yes, please provide details.

* Offers of employment are contingent upon the successful completion of a criminal background check, drug screening, and proof of authorization to legally work in the United States. I understand and wish to continue the application process.

Yes No

* Are you a US Military Veteran, Service Member, or Transitioning Service Member? (Active, National Guard, Reserve)

Yes No

DIVERSITY QUESTIONS

Ethnicity

I identify as Hispanic or Latino.

Select the races you identify with.

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

Gender

Male Female

Voluntary Self-Identification of Disability: Click here for more info on what this means.

Voluntary Self-Identification of Disability

Voluntary Self-Identification of Disability:

Yes, I have a disability or have a history/record of having a disability. No, I do not have a disability and have no history/record of having a disability. I do not wish to answer

VETERAN INFORMATION

Click below to determine your protected veteran classification

Veteran Classification

Veteran Classification, please choose from the below

I am a Protected Veteran. I am not a Protected Veteran. I decline to self-identify.

NOTICE CONSENT—GREGORY ELECTRIC COMPANY, INC.’S ELECTRONIC SIGNATURE POLICY AND ELECTRONIC COMMUNICATIONS

1. Electronic Signature Agreement.

Gregory Electric Company, Inc. (for itself, its subsidiaries, and other affiliates, collectively referred to as “Gregory Electric”) is committed to doing business in the most efficient and effective way possible and has adopted this policy allowing for the use and acceptance of electronic signatures in lieu of manual signatures, as permitted by law.

By selecting “I agree”, you are electronically signing this Agreement. You agree that your electronic signature is the legal equivalent of your manual signature on this Agreement, and you consent to be legally bound by the Agreement’s terms and conditions.

You further agree and consent that your use of a keypad, mouse, or other devices to place your electronic signature or to select an item, button, icon, or similar act/action regarding any agreement, acknowledgment, consent terms, disclosures, or conditions constitutes your signature (your “E-Signature”), acceptance, and agreement as if you signed the document in writing.

You also agree that no certification authority or other third-party verification is necessary to validate your E-Signature and that the lack of such certification or third-party verification will not in any way affect the enforceability of your E-Signature or any resulting contract or agreement between you and Gregory Electric.

2. Consent to Electronic Delivery.

You acknowledge that, if you are hired, you can use your personal account established by Gregory Electric’s HR/Payroll Software/Intranet/Other Chosen Resources to obtain and retain electronically signed documents by printing and/or downloading and saving this Agreement or any other agreements and electronic communications, documents, or records that you sign using your E-Signature.

You further accept electronic delivery of such documents via Gregory Electric’s Chosen Resources as reasonable and proper notice, for the purpose of all laws, rules, and regulations, and agree that such electronic form fully satisfies any requirement that such communications be provided to you in writing.

3. Electronic Execution of Documents.

This Agreement evidences your intent to create binding obligations with Gregory Electric by means of electronic execution of documents. All documents properly electronically executed by means of a “click” in the designated space and/or through the application of an E-Signature shall be considered to be “writing” or “in writing,” and any such document shall be deemed for all purposes: (1) to have been “signed” by you (“Signed Documents”), and (2) to constitute an “original” when printed from electronic files or records established and maintained in the normal course of business.

Signed Documents, if introduced as evidence in any judicial, arbitration, mediation, or administrative proceeding, will be admissible as between the parties to the same extent and under the same conditions as other business records originated and maintained in paper documentary forms.

If you do not agree to the use of your E-Signature to sign documents, forms, agreements, acknowledgments, disclosures, contracts, or other instruments requiring a signature and/or do not consent to the electronic delivery of such documents, contact Gregory Electric’s Human Resources Department to arrange for hard copy delivery of the documents. If you do not agree, do not select “I agree”.

Consent:

I Agree

E SIGNATURE

I hereby certify that all statements provided on this application are true. I understand that any misrepresentation or omission called for in this application or my failure to abide by any company rule or regulation may result in the immediate denial of employment or continued employment.

I authorize Gregory Electric Company to make any investigation and to obtain all lawful information in connection with this application, which it deems necessary to confirm the statements I make in this application, and to circulate such information to the appropriate persons who consider this application. I request and authorize all references and current and former employers to supply information about me verbally or in writing to Gregory Electric Company. In consideration for their furnishing such information, I hereby waive any claims against them which may arise from their furnishing it. I also understand that Gregory Electric Company maintains a Drug-Free workplace and has a Substance Abuse Prevention Process which includes drug testing. I agree to comply with this policy.

NOTHING IN THIS APPLICATION CONSTITUTES AN OFFER OF EMPLOYMENT OR A CONTRACT OF EMPLOYMENT. I UNDERSTAND THAT IF I AM EMPLOYED BY GREGORY ELECTRIC COMPANY THERE IS NO EMPLOYMENT CONTRACT FOR A DEFINITE DURATION. I UNDERSTAND THAT MY EMPLOYMENT IS AT WILL, THAT I HAVE A RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME FOR ANY REASON, AND THAT THE COMPANY HAS A SIMILAR RIGHT. I UNDERSTAND THAT NO COMPANY POLICY, PRACTICE, OR STATEMENT BY ANY COMPANY REPRESENTATIVE SHALL LIMIT OR ALTER THIS AT-WILL RELATIONSHIP. I UNDERSTAND THAT THE RULES, REGULATIONS, POLICIES, PRACTICES, AND PROCEDURES OF GREGORY ELECTRIC COMPANY ARE ADVISORY IN NATURE AND MAY BE CHANGED BY THE COMPANY AT ANY TIME WITHOUT NOTICE.

* Signature (type name)

* Date

Equal Opportunity Employment

We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.

Gender:

Female
Male
I Choose Not to Respond

Race/Ethnicity:

	American Indian or Alaska Native (Not Hispanic or Latino) A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
	Black or African American (Not Hispanic or Latino) A person having origins in any of the Black racial groups of Africa
	Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
	Asian (Not Hispanic or Latino) A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
	White (Not Hispanic or Latino) A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
	Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
	Two or More Races (Not Hispanic or Latino) All persons who identify with more than one of the above races
	I Choose Not to Respond

Veteran Status: (Please check all that apply)

	Vietnam Era Veteran A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
	Disabled Veteran 1) 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 2) A person who was discharged or released from active duty because of a service-connected disability.
	War/Campaign/Expedition Veteran 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.
	Armed Forces Service Medal Veteran 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 No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
	Recently Separated Veteran Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
	I Choose Not to Respond
	Individual with a Disability An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.

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