Page 1 of 4 Notice to Applicant: The Utilities Commission is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status. All employment applications are subject to public disclosure under Chapter 119, Florida Statutes. Position (required) Please enter the position to which you are applying. Personal Contact Information Last Name (required) First Name (required) Middle Name Email Address (required) Phone (required) Cell Phone Street Address (required) City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Referral Source Referral Source Advertisement Employment Agency Friend Relative Other... Referral Source Other... Have you filed an application here before? Yes No If yes, date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031 Have you ever been employed here before? Yes No If yes, date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031 Are you legally eligible for employment in the United States? Yes No (If offered employment, you will be required to provide documentation to verify eligibility) Do you require employer sponsorship of a work visa? Yes No Are you available to work Full-time Part-time Shift Work Are you on layoff from another employer where you have the right to be recalled? Yes No If yes, when do your recall rights expire? Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031 Are any of your relatives employed here? Yes No If yes, list name(s) and relationship. Leave this field blank