Application for Employment

Transcription

1 Application for Employment Conditions of employment are stated at the end of this form. Please read carefully before you sign this application. (Application must be completed in full even if attaching a resume.) POSITION APPLIED FOR DATE OF APPLICATION LOCATION OF POSITION (CITY, STATE) *Please note that if you are working in Marion County, Indiana smoking is prohibited within the company s facilities at all locations due to a local ordinance. NAME (FIRST, MIDDLE, LAST) PERSONAL INFORMATION SOCIAL SECURITY NUMBER PRESENT ADDRESS (STREET, CITY, STATE, ZIP) PRIMARY PHONE: SECONDARY PHONE: ARE ANY OF YOUR RELATIVES PRESENTLY EMPLOYED WITH HKP CORP.? [ ] [ ] IF, NAME OF RELATIVE: HAVE YOU EVER WORKED FOR HKP CORP. BEFORE? [ ] [ ] IF, WHERE? APPROXIMATE DATE: MO/YR. HAVE YOU EVER APPLIED FOR HKP CORP. BEFORE? [ ] [ ] IF, WHERE? APPROXIMATE DATE: MO/YR. HOW WERE YOU REFERRED TO HKP CORP.? HAVE YOU EVER BEEN ACCUSED OR FOUND TO HAVE VIOLATED ANY HARASSMENT POLICY (SEXUAL OR OTHERWISE)? [ ] [ ] HAVE YOU EVER PLED GUILTY TO, PLED CONTEST TO, OR BEEN CONVICTED OF A FELONY OR MISDEMEAR OTHER THAN A MIR TRAFFIC OFFENSE? [ ] [ ]

2 If yes, please explain (attach separate paper if necessary). Note: Criminal convictions will not automatically disqualify an applicant from a particular job. Herman & Kittle will consider the type and seriousness of the crime, whether the conviction(s) substantially relates to the position s functions and qualifications, the frequency of convictions, the applicant s age at the time of conviction, the time elapsed since the date of conviction or completion of jail sentence, the applicant s entire work and educational history, and employment references and recommendations. An exoffender who is denied employment may, upon written request, receive a statement of the reason(s) for denial within 30 days of the applicant s request for such information. Any misinformation or omission with reference to the information furnished will be a basis for disqualification or termination of employment. Do not include convictions that were sealed, eradicated, erased, or expunged, or convictions that resulted in referral to a diversion program. GENERAL INFORMATION IF UNDER THE AGE OF 18, CAN YOU PRODUCE THE NECESSARY WORK PERMIT AT THE TIME OF EMPLOYMENT? [ ] [ ] DO YOU HAVE THE LEGAL RIGHT TO WORK IN THE US? CAN YOU, UPON EMPLOYMENT, PROVIDE GENUINE DOCUMENTATION ESTABLISHING YOUR IDENTITY AND ELIGIBILITY TO BE LEGALLY EMPLOYED IN THE UNITED STATES? [ ] [ ] HAVE YOU EVER BEEN DISCHARGED FROM ANY EMPLOYMENT OR ASKED TO RESIGN? [ ] [ ] IF, PLEASE EXPLAIN: PLEASE CHECK SCHEDULE AVAILABILITY: [ ] I am available and desire to work FULL-TIME (30 hours or more) (Please complete Section B). [ ] I am available and desire to work PART-TIME (Please complete Section B). B. HOURS AVAILABLE MON TUE WED THUR FRI SAT SUN FROM TO TE: WORK SCHEDULES ARE BASED UPON THE NEEDS OF THE BUSINESS AND MAY BE SUBJECT TO CHANGE ON A WEEKLY BASIS. EXPECTED SALARY: WHEN ARE YOU ABLE TO BEGIN WORK?

3 EDUCATION & TRAINING NAME AND CITY/STATE OF SCHOOL MAJOR DEGREE GRADUATED? HIGH SCHOOL/ GED COLLEGE IN PROGRESS COLLEGE IN PROGRESS COLLEGE TECHNICAL, BUSINESS OR TRADE- INCLUDE CERTIFICATIONS IN PROGRESS IN PROGRESS REQUEST FOR TRANSCRIPT OF ACADEMIC RECORDS I hereby authorize the educational institutions listed on the Employment Application to release a copy of my official transcript of my academic record. NAME (PLEASE PRINT) SIGNATURE DATE

4 MOST RECENT EMPLOER EMPLOYMENT HISTORY LIST YOUR LAST FOUR EMPLOYERS, BEGINNING WITH YOUR MOST RECENT. YOU MAY INCLUDE ANY VERIFIABLE WORK PERFORMED ON A VOLUNTEER BASIS, INTERNSHIPS, OR MILITARY SERVICE. PLEASE INCLUDE EMPLOYMENT LAPSES T INCLUDED IN WORK HISTORY. NAME OF COMPANY: ADDRESS TYPE OF BUSINESS: FROM: TO: CITY/STATE/ZIP STARTING SALARY: ENDING SALARY: PHONE. NAME & TITLE OF IMMEDIATE SUPERVISOR: JOB TITLE: DESCRIBE YOUR JOB DUTIES: MAY WE CONTACT YOUR EMPLOYER: [ ] [ ] REASON FOR LEAVING: PREVIOUS EMPLOYERS INFORMATION NAME OF COMPANY: ADDRESS TYPE OF BUSINESS: FROM: TO: CITY/STATE/ZIP STARTING SALARY: ENDING SALARY: PHONE. NAME & TITLE OF IMMEDIATE SUPERVISOR: JOB TITLE: DESCRIBE YOUR JOB DUTIES: MAY WE CONTACT YOUR EMPLOYER: [ ] [ ] REASON FOR LEAVING:

5 PREVIOUS EMPLOYERS INFORMATION (Cont d) NAME OF COMPANY: ADDRESS TYPE OF BUSINESS: FROM: TO: CITY/STATE/ZIP STARTING SALARY: ENDING SALARY: PHONE. NAME & TITLE OF IMMEDIATE SUPERVISOR: JOB TITLE: DESCRIBE YOUR JOB DUTIES: MAY WE CONTACT YOUR EMPLOYER: [ ] [ ] REASON FOR LEAVING: PREVIOUS EMPLOYERS INFORMATION NAME OF COMPANY: ADDRESS TYPE OF BUSINESS: FROM: TO: CITY/STATE/ZIP STARTING SALARY: ENDING SALARY: PHONE. NAME & TITLE OF IMMEDIATE SUPERVISOR: JOB TITLE: DESCRIBE YOUR JOB DUTIES: MAY WE CONTACT YOUR EMPLOYER: [ ] [ ] REASON FOR LEAVING: PLEASE EXPLAIN ANY GAPS IN EMPLOYMENT:

6 COMPUTER SKILLS ARE YOU COMFORTABLE USING A COMPUTER (KEYBOARD, MONITOR, AND MOUSE) WITH OR WITHOUT A REASONABLE ACCOMMODATION? [ ] [ ] PLEASE INDICATE YOUR KWLEDGE LEVEL WITH THE FOLLOWING PROGRAMS: PROGRAM NE BEGINNER INTERMEDIATE ADVANCED PLEASE CIRCLE ANY OF THE BELOW YOU HAVE DONE IN THE CORSPONDING PROGRAM: MICROSOFT WORD CREATING EDITING MAIL MERGE LABELS MICROSOFT EXCEL DATA ENTRY FORMULAS MICROSOFT POWERPOINT SLIDES ANIMATIONS TEXT BOXES MICROSOFT OUTLOOK CALENDAR SCHEDULING OTHER ADDITIONAL EXPERIENCE OR QUALIFICATIONS List any other experience, skills, certifications, professional seminars, or other qualifications, which you believe should be considered in evaluating your qualifications for employment. Please indicate any prior military service that you would like considered in connection with your application for employment.. ATTENDANCE AND PUNCTUALITY INFORMATION Consistent attendance and punctuality are essential requirements of every job with HKP CORP. Are you able to regularly attend work and be punctual if you are offered a job with HKP CORP.? [ ] [ ] If No, please explain

7 NAME: PHONE. PERSONAL OR BUSINESS REFERENCES OCCUPATION: RELATIONSHIP: HOW LONG KWN NAME: PHONE. OCCUPATION: RELATIONSHIP: HOW LONG KWN NAME: PHONE. OCCUPATION: RELATIONSHIP: HOW LONG KWN NAME: PHONE. OCCUPATION: RELATIONSHIP: HOW LONG KWN

8 TIFICATION AND AGREEMENT PLEASE READ BEFORE SIGNING I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACTS ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW THE INFORMATION IS DISCOVERED. Questions regarding this statement should be directed to human resources before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of HKP CORP. to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, and any other characteristic protected by Federal, State or Local law. I authorize the investigation of all statements and information contained in this application (including verbal statements or any submitted documents). I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. I understand that if offered a position with HKP CORP., I am required to submit to a pre-employment background check as a condition of employment, I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of this preemployments test and check will result in withdrawal of any employment offer or termination of employment if already employed. If hired, I agree to abide by all of HKP CORP. s rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either HKP CORP. or me. I further understand that no representation, whether oral or written by any representative or agent of HKP CORP., at any time, can constitute a contract of employment. I understand that HKP CORP. and all Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent of HKP CORP.,= has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President, or to make any agreement contrary to the foregoing. I understand that this application is considered current for three months. If I wish to be considered for employment after this period, I must complete and submit a new application. I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me. APPLICANT SIGNATURE DATE