Employment Application

Are you applying for the job title shown below? If not, please apply for the correct posted position. Applications are received for posted positions only.
Position
Is this the job you are applying for? If not, please apply for correct posted position. Applications are received for posted positions ONLY.*
- Yes

Please complete the employment application below if you are interested in employment at Gulf Coast Electric Cooperative.
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Have you lived less than 5 years at current address?*
- Yes
- No
Previous Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone*
Fax
Email*

Employment History

Must be completed even if you've mailed in your resume.

List your last three employers with the most recent first.
If you are currently employed, may we contact your employer?*
- Yes
- No
Employer*
Start Date*
Month
Day
Year
End Date*
Month
Day
Year
Starting Salary*
Ending Salary*
Contact's Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Supervisor’s Name*
Supervisor’s Job Title*
Your Job Title*
Your Duties*
Reason for Leaving*
Add additional employment history?*
- Yes
- No
Employer*
Dates Employed (MM/YYYY) to (MM/YYYY)*
Starting Salary*
Ending Salary*
Contact's Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Supervisor’s Name*
Supervisor’s Job Title*
Your Job Title*
Your Duties*
Reason for Leaving*
Add additional employment history?*
- Yes
- No
Employer*
Dates Employed (MM/YYYY) to (MM/YYYY)*
Starting Salary*
Ending Salary*
Contact's Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Supervisor’s Name*
Supervisor’s Job Title*
Your Job Title*
Your Duties*
Reason for Leaving*

Professional References
(Please list only references that we may contact at this time)
Reference Name 1
First Last
Title
Company
Home Phone
Work Phone
Add second reference?
- Yes
- No
Reference Name 2
First Last
Title
Company
Home Phone
Work Phone
Add third reference?
- Yes
- No
Reference Name 3
First Last
Title
Company
Home Phone
Work Phone
Add fourth reference?
- Yes
- No
Reference Name 4
First Last
Title
Company
Home Phone
Work Phone

Applicant Consent*
I hereby verify the above information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.
Nonbinding Application and Interview Process: I understand that this application will be reviewed, but nothing in this application or any other documents or in the employment evaluation process shall be construed as either an offer or contract of employment or an obligation on the part of Gulf Coast Electric Cooperative to provide any benefit to me.

Employment-At-Will: I understand that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either Gulf Coast Electric Cooperative or myself.

I hereby declare that my statements on this application and on my resume or documents provided by me to Gulf Coast Electric Cooperative are true and correct to the best of my knowledge. I acknowledge and agree that providing any false information may result in a decision not to hire me, or if hired, may result in the termination of my employment. I also authorize investigation of these statements. This investigation may include employment history, reasons for leaving previous employers, criminal record, credit record, driving record, social security number investigation, and degree/certificate verification. I authorize the listed references and all of my previous employers to provide you with any and all applicable information they may have. I hereby release these references and previous employers from all liability for any information they may give you. I hereby release Gulf Coast Electric Cooperative from all liability for any damages resulting from the information obtained. This application shall be considered active for a period of time not to exceed 180 days.
Applicant Electronic Signature (Full Name)*
Name
This field is for validation purposes and should be left unchanged.

Type of Education	Name, Location (City, State, Country), Phone Number	GPA	Did you graduate?	Degree Earned

Employment Application

Step 1 of 7

Education and Training

Employment History

Professional References

PowerSouth’s 2023 FEMA Pre-Storm RFP Program

Step 1 of 7

Education and Training

Employment History

Professional References