Apply | Killen Contractors Inc

Job Application Form

KCI Job Application

We look forward to learning more about you.

First Name

Last Name

Date of Application

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Telephone

Date of Birth

Emergency Contact

Emergency Phone Number

Type of Employment Desired

Full Time

Part Time

Temporary

Date you will be available to work.

Are you able to meet the attendance requirements?

Yes

Do you have any objection to working overtime if necessary?

Yes

Can you travel if required by this position?

Yes

Have you ever been employed by our organization?

Yes

Can you submit proof of legal employment authorization and identity?

Yes

If you are under 18, can you submit a work permits if it is required?

Yes

Have you been convicted of a crime in the last 7 years?

Yes

If yes, please explain ( a conviction will not automatically bar your employment)

How were you referred to us?

Job History

Job 1

Employer

Position Held

Supervisor's Name

Supervisor's Phone Number

Dates Employed M/Y-M/Y

Salary/Hourly Pay

Job Summary

Reason For Leaving

Job 2

Employer

Position Held

Supervisor's Name

Supervisor's Phone Number

Dates Employed M/Y-M/Y

Salary/Hourly Pay

Job Summary

Reason For Leaving

Other Skils and Qualifications

Summarize Job-related training, skills, license, certificates, and/or other qualifications:

Education

High School

Name of High School

Years Completed

Field of Study

Degree

College

Name of Institution

Years Completed

Field of Study

Degree

Technical Training

Name of Institution

Years Completed

Field of Study

Degree

Please list your references as follows: Name, Phone #, Years known (one reference per line)

By Clicking Submit, I hereby authorize the potential employer to contact, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered. If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or Killen Contractors Inc. can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law. I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA. I also understand that if employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

I have read and agree to the aforementioned Terms & Conditions.