Employment Application - Elliott Electric Supply

Employee Application

Personal Information

Elliott Electric Supply is an Equal Opportunity Employer and shall not, because of race, color, religion, age, sex, national origin, or handicap, fail or refuse to hire qualified applicants.

**Required Information
- First Name (Nombre) **
  
  Last Name (Apellido) **
- Middle Name
  Leave blank if none
  
  Preferred Name
  Leave blank if none
  
  Suffix
  Leave blank if none
- Current Street Address **
  (Street Name and Number)
  
  Apt. #
- City **
  
  State **
  
  Zip Code **
- Cell Phone Number
  ex.(123)123-1234
  
  Home Phone Number
  ex.(123)123-1234
  
  Social Security #
  123-12-1234
  - -
- Upload Resume (optional):
  The file should be in ".doc", ".docx" or ".pdf" format.
  Maximum file size accepted is 4 MB.
  
  You attached an empty resume. It will not be included. Please double check the file that you uploaded.
Create Application Login

Enter the following information to create a login. Your application will not be saved or submitted until you click the "Submit Application" button on the last step.

I do not have an email address

Email Address **

Please re-enter your Email Address **
(must match exactly)

You'll be using your phone number for your login. Please re-enter your home phone number. If a home phone number is not available, please use your cell phone number.

Phone number: **
ex.(123)123-1234

Password **
Only alphanumeric characters are allowed.

(Password must be longer than 6 characters and must contain at least 1 number and at least 1 letter)

Re-enter your Password**
(must match exactly)