Career

Apprentice Application For Employment

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Horner Electric, Inc. and its individual companies, Horner Industrial Services and Horner APG, LLC, are Equal Opportunity Employers and do not discriminate on the basis of age (as defined by applicable law), religion, sex, race, color, sexual orientation, national origin, disability or veteran status. It is our intention that all qualified applicants have equal opportunity and that selection decisions be based on job-related factors. Any applicant needing reasonable accommodation throughout the application and/or employment selection process should notify the Human Resources Department at 317-639-4261. Horner Electric, Inc. will provide reasonable accommodations to disabled applicants.

Date of Application(Required)

MM slash DD slash YYYY

Name(Required)

First Middle Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone

Email(Required)

Education

Are You a High School Graduate(Required)

Yes

If No, Do you have your GED?

Yes

Have you used fractions or decimals when measuring or working with tools?(Required)

Yes

Have you completed any vocational technical courses or training during or after high school?(Required)

Yes

If Yes, how long was the program?

Did you complete the program?

Yes

List College Degree(s) earned, including Degree, Major and School:(Required)

Are you 18 years of age or older?(Required)

Yes

If not, state your age for child labor law purposes only:

Please enter a number from 0 to 18.

If hired, can you furnish proof you are eligible to work in the U.S.?(Required)

Yes

Background

Have you ever served in the U. S. military?(Required)

Yes

Have you ever been convicted of a violation of the law (except a minor traffic violation or sealed record)?(Required)

(A “yes” does not automatically disqualify you from employment since the nature of the offense, date, and the job for which you are applying will be considered.)

Yes

If yes, give details:

Do you have a valid driver’s license?(Required)

Yes

Have you ever worked on or helped at a farm?(Required)

Yes

Have you worked on or taken apart vehicles?(Required)

Yes

Do you have any of the following experiences: Small Electrical Motors(Required)

Yes

Electrical / electronic / construction experience outside of your work experience:(Required)

Yes

Can you read and work from a blueprint?(Required)

Yes

Do you have experience with testing equipment (micrometers, calipers, multimeters) ?(Required)

Yes

Interest & Ability

List the reason or reasons you are applying for this apprenticeship program:(Required)

Do you have reliable transportation to get to and from work for all scheduled shifts?(Required)

Yes

Are you able and willing to attend all related trainings as required to complete your apprenticeship?(Required)

Yes

Share with us briefly what skills do you hope to gain from this apprenticeship?(Required)

Work History

1.

Company(Required)

Position(Required)

Position Type(Required)

Full-time

Part-time

Duties(Required)

Company Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Finish Salary(Required)

2.

Company

Position

Position Type

Full-time

Part-time

Duties

Company Address

Street Address City State / Province / Region ZIP / Postal Code Country

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Finish Salary

3.

Company

Position

Position Type

Full-time

Part-time

Duties

Company Address

Street Address City State / Province / Region ZIP / Postal Code Country

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Finish Salary

Voluntary Affirmative Action Form

The information requested within this section will be used solely to record information as part of our Affirmative Action Program.

Your provision of this information is optional. Your decision not to complete this section will not affect consideration of your application or subject you to any adverse treatment. Upon completion, his information will be separated from the application and only accessed by the Human Resources Department.

Thank you for your cooperation.

Applicant Information

Name

Date

MM slash DD slash YYYY

Race or Ethnic Identity

Please check one of the descriptions below corresponding to the ethnic group with which you identify.

Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

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.

American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.

Gender

Male

Female

Veteran Status

Vietnam Era Veteran

Special Disabled Veteran

Other Protected Veteran

Recently Separated Veteran

Armed Forces Service Medal Veteran

I do not wish to Self-Identify

Signature

Name

First Last

Date

MM slash DD slash YYYY

EEO Policy

Horner Electric, Inc. maintains a policy of non-discrimination for all employees and applicants in every facet of the company’s operation. In compliance with federal and state laws, Horner Electric, Inc. hires, trains, and promotes all qualified employees without unlawful discrimination on the basis of race, color, sex, age, religious creed, marital status, citizenship, national origin, physical or mental handicap. This policy also applies to disabled veterans and veterans of the Vietnam Era.

Applicant’s Certification and Agreement:

It is very important that you read this section carefully and that you fully understand it before you sign it. This section affects your legal rights.

Applicant’s Certification and Agreement:(Required)

I certify that the information contained in this application is correct to the best of my knowledge and understand that any falsification, misrepresentation or omission on this application is grounds for refusal to hire, or, if hired, termination. I authorize any of the persons or organizations referenced in this application to give Horner Electric, Inc. any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties and Horner Electric, Inc. from all liability for any damage that may result from furnishing such information. I authorize Horner Electric, Inc. to request and receive such information.

Horner Electric, Inc. participates in E-Verify, an internet-based system that allows an employer to confirm the eligibility of an employee to work in the United States. The E-Verify system is operated by the U.S. Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA). Through E-Verify, employers transmit information provided by the employee on the Form I-9 to the SSA and DHS to ensure authorization to work in the United States. It also validates that your name, social security number, date of birth, citizenship status, and any other non-citizen information you provide your employer on the Form I-9 are consistent with government records.

If employed, I understand that I will be an employee “at will” and either Horner Electric, Inc. or I may terminate my employment relationship at any time with or without notice for any reason that does not violate the law.

I agree to comply with Horner Electric, Inc.’s rules, regulations and policies, and acknowledge that these rules, regulations and policies may be changed, interpreted, withdrawn or supplemented at any time, and without prior notice to me.

I acknowledge that any offer of employment, or my acceptance of an employment offer, if such is to occur, may be withdrawn with or without cause, and with or without prior notice, at any time, at the option of Horner Electric, Inc. or myself. I understand that this application and any other documents that I may receive are not contracts of employment. I further understand that no representative of Horner Electric, Inc. other than an officer has any authority to enter into any agreement for employment for any specified period of time or to assure any other HRFM-21 Rev. 08/07/2014 personnel action, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or make any agreement contrary to the foregoing.

I understand and agree that work schedules and requirements vary and can be unpredictable, and that, while Horner Electric, Inc. will make reasonable efforts to accommodate work schedules and employee availability, I may be required to work overtime, weekends, different shifts or other agreements. I consent to these requirements as necessary and legitimate conditions of employment.

I have read and understand everything on this application.(Required)

Name(Required)

First Last

Today's Date(Required)

MM slash DD slash YYYY

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Career

Apprentice Application For Employment

Education

Background

Interest & Ability

Work History

1.

2.

3.

Voluntary Affirmative Action Form

Applicant Information

Signature

EEO Policy

Applicant’s Certification and Agreement:

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