APPLICATION FOR EMPLOYMENT of Emera Maine

Emera Maine
P.O.
Box 932
Bangor, ME 04402-0932
Website:
Email:
Fax: (207) 973-2813
APPLICATION FOR EMPLOYMENT
Emera Maine is an Equal Opportunity Employer. Applicants are
considered for all positions and all employees are treated during
employment without regard to race, color, religion, sex, sexual
orientation, age, disability, Vietnam Era and/or disabled veteran
status, national origin or any other characteristic protected under
federal, state or local law, and to affirmatively seek to advance the
principles of equal employment opportunity.
Name:
Last First Middle
Date:
Address:
Home Telephone: ( ) Hours you may be reached:
Work Telephone: ( ) May we contact you at work? Yes No
Position Applying For: Full-time Part-time
Have you ever worked at Emera Maine?
Department Date
Have you ever applied to Emera Maine?
Last Position Date
Are you 18 years of age or older (required for compliance with child labor laws)? If no, can you furnish a work permit, if
required? Are you currently authorized to work and remain in the United States? (Appropriate documentation will
be required upon offer and acceptance of employment.) Based on the job description, are you able to perform the essential functions
of this job with or without a reasonable accommodation?
Do you have relatives employed at Emera Maine?
Name Department Relationship
Do you have a current Maine Driver’s License? Yes No
If yes, what type? Class A Class B Class C Endorsements?
List all current and previous jobs and activities including part-time employment while in school, self-employment, volunteer work
and periods of unemployment. Exclude organization names which indicate race, color, religion, sex, sexual orientation, age,
disability, Vietnam Era and/or disabled veteran status, national origin or any other characteristic protected under federal, state or local
law. Begin with your present or most recent position.
1)
Employer Telephone Dates Worked
Address Street City State Position Title
May we contact your current employer? Name and Title of Supervisor
Reason for Leaving:
2)
Employer Telephone Dates Worked
Address Street City State Position Title
Name and Title of Supervisor
Reason for Leaving:
3)
Employer Telephone Dates Worked
Address Street City State Position Title
Name and Title of Supervisor
Reason for Leaving: ---
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