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Employment Application
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Your Personal Information
Your Name
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General Information
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Email
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DL Number
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DL State
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Social Security Number
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Date Available For Work
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Education
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City
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Course/Degree
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Graduate
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GED
Tech School
City
Course/Degree
Graduate
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GED
College
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Course/Degree
Graduate
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GED
Military Training
Please describe any job-related military training you received.
Professional Memberships
Please list any present memberships in any professional, technical, trade, or employment-related associations (excluse those groups which indicate age, disability, race, creed, color, sex, pregnancy, national origin, or veteran status)
COMPLETE THE FOLLOWING SECTION WHERE RELEVANT TO THE POSITION FOR WHICH YOU ARE APPLYING
Trade / Technical School / Journeyman / Technical Certificate
Yes
No
Certificate Number
State Attained
Other Relevant Skills
List any other relevant skills, courses, qualifications, types of equipment operated
Availability
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Are you currently on Lay-Off and subject to recall?
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Legal Availability
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Are you legally entitled to accept employment in the USA?
Yes
No
Hobbies & Interests
Previous Employment
Employer
*
City, St
*
Title
*
Phone
*
From
*
To
*
Supervisor
*
Job Duties
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Last Rate of Pay
*
Reason for leaving
*
Activities / Committees / Etc
Exclude activities / committees / etc which indicate age, disability, race, creed, color, sex, pregnancy, national origin, or veteran status
Employer
City, St
Title
Phone
From
To
Supervisor
Job Duties
Last Rate of Pay
Reason for leaving
Activities / Committees / Etc
Exclude activities / committees / etc which indicate age, disability, race, creed, color, sex, pregnancy, national origin, or veteran status
Employer
City, St
Title
Phone
From
To
Supervisor
Job Duties
Last Rate of Pay
Reason for leaving
Activities / Committees / Etc
Exclude activities / committees / etc which indicate age, disability, race, creed, color, sex, pregnancy, national origin, or veteran status
May we contact the employers listed above for reference purposes?
*
Yes
No
Have you ever been employed by Kelly Construction?
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Yes
No
When were you employed by Kelly Construction?
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References
List persons, preferably business or work associates, other than relatives and previous employers.
Name
*
Address
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Occupation
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Phone
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Name
*
Address
*
Occupation
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Phone
*
Name
*
Address
*
Occupation
*
Phone
*
Conditions of Employment
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I agree that the information contained in this application is true to the best of my knowledge and belief. I understand missrepresentation of fact, as stated or implied on this or any other employment form, may be sufficient reason not to hire me and may be cause for dismissal.
I understand that Kelly Construction of Davenport, Inc. is not obligated to provide employment and that I am not obligated to accept employment. Nothing in this application, or in any prior or subsequent oral or written statements, is intended to create any contract of employment or to create rights in the nature of a contract of employment. This application does not bind either party for a specific period of time regarding employment. I understand that no one other than the President of Kelly Construction of Davenport, Inc. has any authority to enter into any agreement contrary to the foregoing. If hired, nothing in thei application shall restrict my right as an employee of Kelly Construction of Davenport, Inc. as an employer to terminate my employment at any time.
I understand that if hired I will be subject to a minimum introductory period of ninety (90) days. During this period it is my responsibility to demonstrate suitability for the position for which I was hired. I am required to abide by Kelly Construction's safety and work rules and any other policies and procedures, and if I violate them, I will be subject to disciplinary action.
I authorize investigation by Kelly Construction of Davenport, Inc. of all statements contained in this application. I waive any right I may have to notice from any persons listed on this application prior to the release of any employment information to Kelly Construction of Davenport, Inc.
I agree to the employment conditions.
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