Read This First Please complete the following questionnaire. All information provided will be handled with the utmost discretion. We realize these forms will take you some time to complete. Employers today often prefer information supplied to them in electronic format. The more information you supply to us online, the quicker we can assist your job search. You may discreetly share information about me whenever you think appropriate positions come up to all but my present employer. Please do not send out any information about me without contacting me first. Candidate Application (Form A) — General Information Nickname Your Title Mr. Mrs. Ms. Dr. First Name Middle Initial/Name Last Name Street Address Apartment or Unit Number City State/Prov Zip/Postal Code Country This is a permanent address. This is a temporary address. Home Phone w/Area Code Work Phone w/Area Code Pager w/Area Code Cell Phone w/Area Code Fax w/Area Code Is this a Home Fax? or a Work Fax? Main Email Address Alternate Email Address If you do not have an email address, please enter "noemail@lineal.com", without the quote marks, in the above box. Email a copy of the data from these forms to your Main Email Address Do not email copy of the data from these forms Can receive calls at work, if handled discreetly? Yes No Are you legally entitled to work in the US? Yes No For housing, check all that apply Own your home Rent your home Live with parents Military housing Have other living arrangements Please indicate if someone other than yourself is completing this form. No Yes Very Important! Please supply us with the name, relationship and phone number of someone not living with you who will know your whereabouts, should you relocate, change phone numbers, etc. Name Relationship (parent, relative, friend, etc.) Phone number w/area code Current Employment Information If you are currently unemployed, please provide the information for the most recently held job. Current Position Current Company Affiliate or Parent Company Date Started Date Finished Check if still employed Total number of years in the electrical/ mechanical/ electronics industry Approximately how many people work in your shop or facility? Approximately how many people (if any) do you supervise? Current BASE salary $ hourly monthly yearly Last year's W-2 total earnings including base, commissions, overtime, bonuses, etc. $ Realistic salary expected in a new position $ hourly monthly yearly Do you presently receive Company Car Yes No Paid Overtime Yes No Bonus Yes No Commission Yes No Paid Expenses Yes No Total Bonus and Commission expected this year I have worked union non-union managed union managed non-union Presently, I am a union member non-union What languages do you read, write and speak reasonably well? English Arabic Chinese French Hindi Japanese Russian Spanish Languages other than above that you read, write and speak reasonably well If you are currently in the Military, please indicate end of obligated service (mm/yy) What is your MOS or military specialty? Briefly, why do you want to change jobs? Briefly, what are your greatest strengths? Travel and Relocation Preferences I now travel none light moderate heavy I will travel none light moderate heavy Assuming you are presented with a reasonably good opportunity in a reasonably nice area, what chance is there that you would relocate? excellent very good good fair remote none Indicate which statement best describes you/your family's feelings on relocation 1. I/we will relocate. 2. I/we prefer to relocate. 3. I/we will relocate, but only to the areas listed below. 4. I/we would relocate, but not before (mm/yy) 5. I/we strongly prefer not to relocate. 6. I/we will not relocate. What areas are you willing to consider for relocation? South Midwest Southeast Northeast Southwest Northwest Canada Mid-Atlantic Overseas Continental U.S. No preference Will not relocate I/we prefer metro area medium town rural area I/we prefer the following specific area(s) / cities Which states/locations would you be most interested in hearing about (willing to relocate to)? Please use the list below. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Wash. DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York N. Carolina N. Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island S. Carolina S. Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Educational Background Please select the category or categories below that best describe your educational background. Ph.D. or Doctorate Electrical Eng. or EET Mechanical Engineering Electronics Industrial Engineering Physics Aerospace Computers/IT Marine Power Systems Business Marketing Other Masters or MBA Electrical Eng. or EET Mechanical Engineering Electronics Industrial Engineering Physics Aerospace Computers/IT Marine Power Systems Business Marketing Other Bachelor's, BA, BS, or 4 year degree Electrical Eng. or EET Mechanical Engineering Electronics Industrial Engineering Physics Aerospace Computers/IT Marine Power Systems Business Marketing Other Associates or 2 year degree Electrical Eng. or EET Mechanical Engineering Electronics Industrial Engineering Physics Aerospace Computers/IT Marine Power Systems Business Marketing Other Apprenticeship / Certificates / Licenses Apprentice Journeyman 52E Military Training NETA Professional Engineer Nuclear Certified Some College - No Degree Thermography Vibration Analysis Votech Millright Other Experience, Product Knowledge, Skills — Please Read This Now Below are three important lists. Please choose ONLY the boxes where you have SUBSTANTIAL EXPERIENCE. Please try to limit the number of desired positions to 10. Checkmarks of categories that appear in boldface will prompt additional, in-depth technical questions in FORM B. Experience Previous Experience and Desired Position(s) Substantial Experience Desired Position Experience/Position Winder Motor Repair Mechanic / Apparatus Repairman On-site Work Test & Inspect Machinist Welding Coil Manufacturing Generator Specialist Diesel Generator/Engine Mechanic Substantial Experience Desired Position Experience/Position Leadman, In-shop or Working Foreman On-site Lead Person Electrical Foreman Mechanical Foreman General Foreman Shop Superintendent Plant or Shop Operations Manager Plant Engineer Production Control/Scheduler Quality Control & Assurance Substantial Experience Desired Position Experience/Position Customer Service Representative Customer Service Supervisor Application Engineer Inside Sales New Equipment Sales Service Sales Product and/or Marketing Manager R&D Product Development Engineer/Mgr Instructor / Trainer Sales Manager General Manager Regional / Division Manager / President Substantial Experience Desired Position Experience/Position Circuit Breaker Technician Switchgear Specialist Field Service Engineer Field Service Technician Start-up - Commissioning / Tech / Engineer / Mgr Transformer Field Service / Test Repair SCADA Engineer / Technician NETA Certified Engineer / Technician Instrumentation / Control Technician Protective Relay Engineer Power Systems Engineer Substantial Experience Desired Position Experience/Position Service Coordinator Engineering Supervisor Engineering Manager Manager, Engineering Services Substantial Experience Desired Position Experience/Position Project Engineer Project Manager Specification Engineer Quoting/Estimator Design Engineer Design Manager Substantial Experience Desired Position Experience/Position UPS Engineer / Technician / Manager Electronics Engineer Electronics Repair Power Quality Engineer Substantial Experience Desired Position Experience/Position Process Control Engineer Manufacturing Engineer Mechanical Engineer Electrical Engineer Manager, Parts Manufacturing Substantial Experience Desired Position Experience/Position Electrical Utility Engineer / Technician Power Plant/Control Room Operator/Engineer Reliability Engineer Rotating Machinery Vibration Engineer/Tech Facility Maintenance Engineer/Tech/Mgr Maintenance Mechanic Predictive / Preventive Maintenance Substantial Experience Desired Position Experience/Position Geothermal Power Expertise Hydro Power Expertise Nuclear Power Expertise Solar Power Expertise Wind Power Expertise Wind Power Up-Tower Expertise Wind Farm Expertise Please describe any positions you have held that are not covered here or related positions you would like to have in the future. Product Knowledge Anti-Friction Bearings Babbitt Bearings Commutators / Brushes Circuit Breakers Coils Compressors Controls Power Distribution/Transmission Equipment Drives / Inverters Rotating Apparatus Drive Systems Generators Turbine Generators Hoists & Cranes Insulation / Varnish Motors Rotating Apparatus Motor Control Centers Servo Motors Hydros Programmable Controllers Pumps Robotics Seals Sleeve Bearings Solid State / Electronic Components Switchgear Test Instruments Lifting Magnets Welders Wire & Cable Transformers UPS 3 phase power conversion equipment Substations Protective Relay Systems Governors Switchboards Other Products Personal Skill Set Alignment / Balancing Assembly / Disassembly Coil Manufacturing Design Dynamic Balancing Estimating / Quoting Field Servicing Flame Spray Infra-Red Scanning / Thermography Installation Installation Supervision Lathe Work Machining Manufacturing Management Mechanical Repair Production Scheduling Sales New Equipment Sales Service Start Up / Commissioning Surge Testing Trouble Shooting Vibration Analysis VPI Welding Winding Circuit Breaker Retrofit and Refurbishing On-site work Power System Studies Turnkey Projects Protective Relay Systems Proposal Writing Specification Work Switchgear modification / redesign Other Skills Other General Skill Information Can you fabricate from drawings? Yes No Somewhat Can you read blueprints/design prints? Yes No Somewhat Can you read schematics? Yes No Somewhat Can you read wiring diagrams? Yes No Somewhat Rate your level of expertise and familiarity with computers Type of computers and software used List any licenses, certificates, or specialized training Please choose one of the following: "I am strongest in…" Rotating Apparatus ie: motors, generators, (or mechanical repair i.e., pumps.) Electrical/Electronic Power Equipment ie: switchgear or controls. Both of the above equally. Other Please Click the Submit Button Only Once! It will take a few seconds to respond to the click. Please do not click it again—you may have to re-complete and re-submit the form again. There is a great deal of data being processed, please be patient. It may take a minute or so to get to FORM B.
