Employment Application (PDF)




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Author: Denise Cotter

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APPLICATION
FOR
EMPLOYMENT

Date __________________________
Position Applied For
______________________________

We are an equal employment opportunity employer. As such, we will not discriminate unlawfully against any
applicant for employment or any employee because of race, color, religion, sex, age, national origin, ancestry,
citizenship, disability, veteran or marital status.

Personal
Name ________________________________________________ Social Security No. __________________
Last

First

Middle

Present Address __________________________________________________________________________
No.

Street

City

State

Zip Code

How long have you lived at this address? ___________________ Telephone No. _______________________
Email Address ___________________________________________________________________________
Have you worked for us before? _____________ If yes, when? _____________________________________
Do you want to work Full-Time or Part-Time? If part-time, specify days and hours available to work
________________________________________________________________________________________
If hired, when will you be available for work? ___________________________________________________
Do you have a reliable method of transportation to get to work? ____________________________________
Do you have the legal right to work in the United States? _________________________________________
Are you 18 years of age or over? __________ If no, employment is subject to verification that you are of
minimum legal age for the job for which you are applying.
Have you been convicted of a crime in the past ten years, excluding only minor traffic violations? _________
If yes, describe the crime, date, location of conviction and penalty:__________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Is there any reason that you cannot perform any of the duties listed in the description of the job for which you
are applying, with or without accomodation? ________If yes, describe the work limitations and possible
accomodations:___________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

KMC Form U-989A

1 of 3

02/13/14

Employment History
(List in order with last or present employer first)
May we contact your current and previous employers for reference? Yes _____ No _____
A. Name of Company
B. Street Address
C. City & State

Dates Employed
Month

A.

From

Position

To

Last Salary

From

Position

To

Last Salary

From

Position

To

Last Salary

From

Position

To

Last Salary

From

Position

To

Last Salary

B.
C.
A.
B.
C.
A.
B.
C.
A.
B.
C.
A.
B.
C.

Positions
and
Wages or Salary

A. Name of Supervisor
B. Phone Number
C. Reason for Leaving

A.
B.
C.
A.
B.
C.
A.
B.
C.
A.
B.
C.
A.
B.
C.

Education
Elementary: ____________________________________________________________ Did you graduate? ___________
Name and Address

If no, what was the last year completed?_______________
======================================================================================================================================

High School: ___________________________________________________________ Did you graduate? ___________
Name and Address

If no, what was the last year completed? _______________
======================================================================================================================================

College: ______________________________________________________________ Did you graduate? ____________
Name and Address

If no, what was the last year completed? _______________ What was your major? __________________________________
What was your degree earned? _______________________________________________________________________
======================================================================================================================================

Business or Trade School: _________________________________________________ Did you graduate? ___________
Name and Address

If no, what was the last year completed? _______________What was your major? ___________________________________
What was your degree earned? _______________________________________________________________________
======================================================================================================================================

List any additional experiences, skills, training, or schooling not covered above which you feel would qualify you to work for this
company:___________________________________________________________________________________________

KMC Form U-989A

2 of 3

02/13/14

Indicate years of experience for each listed below
Maintenance:

Office Skills:

________ Plumbing Repairs
________ Painting
________ Electrical Repairs
________ Boilers
________ Grounds
________ Plastering and Wall Board
________ Appliance (Small)
________ Appliance (Major)
________ Swimming Pool/Spa
________ Lock and Key
________ Carpentry

________ 10 Key Adding Machine
________ Typing/WPM
________ Bookkeeping
________ Facsimile Machine
________ Filing System
________ Monthly-Weekly Reports

Rental Skills:
________ Sales Experience
________ Rental Sales Experience
________ Telephone Communication

Military Service
Are you a veteran of the United States Armed Forces? _______ If yes, did you receive any training which
will be helpful on the job for which you are applying?
_____________________________________________________________________________________
_____________________________________________________________________________________

Personal References excluding former employers or relatives
Name
Address
Phone
No. Yrs Known
——————————————————————————————————————————
1.
——————————————————————————————————————————
2.
——————————————————————————————————————————
3.

Applicant Acknowledgment: Please read carefully before signing.
In signing and submitting this application for employment to Key Management Company, I hereby certify, understand and
agree: 1. That the information contained in this application is correct and complete to the best of my knowledge and
understand that any omission, misrepresentation or falsification of information made herein or in any interviews is grounds for
refusal to employ me or my dismissal if I am employed; 2. That the references listed above, schools and current and past
employers may give the Company any and all information concerning my previous employment and any information they may
have, persoan or otherwise, and I release all parties from all liability for any damage or claim that may result from furnishing
the same to the Company; 3. If I am employed, I will abide by the rules, regulations and policies of the Company, and that my
employment and compensation can be terminated, with or without cause at any time, at the option of either the Company or
myself; and 4. That no representative of the Company, other than the President of the Company, has any authority to enter into
any agreement for employment for any specified period of time, or make any agreement contrary to the foregoing.

_____________________________________________________________________________________________
Signature of Applicant

KMC Form U-989A

Date

3 of 3

02/13/14






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