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EMPLOYMENT AT KOLACIA CONSTRUCTION INC.

Application For Employment

Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap or veteran status.

PERSONAL

Last Name

First Name

Middle Name

Date

Home Number

Cell Phone

Address

City, State, Zipcode

Have you ever applied for employment with us? If yes, Month and Year

Social Security Number

Are you legally eligible for employment in the United States?

Position Desired

Pay Expected

Are you available for full-time work? If not, what hours can you work?

Will you work overtime if asked?

When can you start work?

Are you willing to take a drug screening test before you would be eligible to work for Kolacia Construction, Inc.?

Other special training or skills (languages, machine operation, CDL, etc.)

EDUCATION

Graduate School (Name & Location)

Course of Study

Number of Years Attended

Did You Graduate

Degree or Diploma

Collage (Name & Location)

Course of Study

Number of Years Attended

Did You Graduate

Degree or Diploma

Technical / Trade School (Name & Location)

Course of Study

Number of Years Attended

Did You Graduate

Degree or Diploma

High School (Name & Location)

Course of Study

Number of Years Attended

Did You Graduate

Degree or Diploma

BACKGROUND

The following information is needed for legally permissable reasons, including, without limitation, a legitimate occupational qualification or business necessity.

Do you currently hold a valid drivers license? If no, please explain

Have you ever suffered any back or neck problems? If so, when?

Do you have any physical or health problems that would hinder work performance in the construction field? If so please explain

Have you ever been convicted of a crime, other than minor traffic offenses?

EMPLOYMENT

Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.

1. Company Name

Address

Employment Duration (state month and year)

Name of Supervisor

Hourly Wage

State Job Title & Describe Your Work

Reason For Leaving

2. Company Name

Address

Employment Duration (state month and year)

Name of Supervisor

Hourly Wage

State Job Title & Describe Your Work

Reason For Leaving

3. Company Name

Address

Employment Duration (state month and year)

Name of Supervisor

Hourly Wage

Reason For Leaving

State Job Title & Describe Your Work

REFERENCES

Give the name of three persons not related to you, whom you have known at least one year.

1. Name

Adress

Business

Year Acquainted

2. Name

Adress

Business

Year Acquainted

3. Name

Adress

Business

Year Acquainted

EMERGENCY

In case of an emergency, who should we notify?

Full Name

Phone Number

Address

SIGNATURE

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

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