Residential Commercial Appliances Safety About Contact PAY BILL Employment Application Home/Employment Application Fill out the form below to apply for employment. If you’d like to apply in person, download the application, print and fill out. Drop it by our main office in Fort Payne or Centre. Applicant Information Last Name First Name Date Street Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington 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 North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip Phone Email Date Available Desired Salary Position Applied for Are you a citizen of the United States?YesNo If no, are you authorized to work in the United States?YesNo Have you ever worked for this company?YesNo If so, when? Have you ever been convicted of a felony?YesNo If yes, explain Education High School Address From to Did you graduate?YesNo Degree College Address From to Did you graduate?YesNo Degree Other Address From to Did you graduate?YesNo Degree References Please list three professional references. Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address Previous Employment Company Phone Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From to Reason for Leaving May we contact your previous supervisor for a reference?YesNo Company Phone Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From to Reason for Leaving May we contact your previous supervisor for a reference?YesNo Company Phone Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From to Reason for Leaving May we contact your previous supervisor for a reference?YesNo Military Service Branch From to Rank at Discharge Type of Discharge If other than honorable, explain I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.YesNo Need Help? Our customer service team is ready to answer any of your questions! Call us at 256.845.3731 or email us and we'll get back with you as quickly as possible. DEKALB COUNTY LOCATIONS DeKalb-Cherokee Counties Gas District Main Office 1405 Gault Ave South Fort Payne, AL 35967 256.845.3731 Toll Free: 800.239.5606 Fort Payne Customer Service Center 1411 Chitwood Ave SE Fort Payne, AL 35967 256.845.8932 CHEROKEE COUNTY LOCATION Centre Customer Service Center 1401 W. Main St. Centre, AL 35960 256.927.5925 ACCEPTS PAYMENTS FOR DC GAS Collinsville Utilities 170 Main St. Collinsville, AL 35961 © DeKalb-Cherokee County Gas District | Policies