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#161222-332300-001
Supplemental Questionnaire

Last Name
First Name
 

Do you possess a valid Driver's License?
Yes No
 

Do you have a minimum of three (3) years of working experience in industrial electrical troubleshooting, maintenance and repair?
Yes No
 

If you answered, "YES" to question # 2, please describe your work experience in that specific area(s).
 

Do you have direct experience working with voltages up to 13,800 volts?
Yes No
 

Please select your role and it relates to the industrial electrical industry. ( Select all that apply)
No Experience
Installer
Maintenance/ Repair
Troubleshooting
 

Please describe a time when you had to troubleshoot an electrical issue.