Employment Application

Personal Information

NAME (Last) *

NAME (First) *

NAME (Middle)

NAME CALLED BY

STREET ADDRESS *

CITY *

STATE *

ZIP *

YEARS AT THIS ADDRESS *

TELEPHONE # *

EMAIL ADDRESS *

Do You Have A Valid PA Drivers License? *

YES

NO

Drivers License #

List Prior Addresses Over Past Five Years In Reverse Order

ADDRESS

How Long

ADDRESS

How Long

ADDRESS

How Long

ADDRESS

How Long

ADDRESS

How Long

Employment Questions

Have You Ever Been Previously Employed By Kriger Construction? *

YES

NO

Do you have the Legal Right To Work Permanently In The U.S.? *

YES

NO

If No Explain

Have you Ever Been Convicted of A Crime? *

YES

NO

If Yes Explain

Do You Have Any Physical Limitations Which May Limit Your Ability To Perform The Job Applied For. If Yes, Explain

How did you hear about the employment opportunity?

NAME

RELATIONSHIP

NAME

RELATIONSHIP

NAME

RELATIONSHIP

NAME

RELATIONSHIP

Travel

Are You Willing To Travel? *

YES

NO

Education

Extra Curricular Activities And Honors ( Do not Include Racial, Religious, Or nationality Groups)

Work Experience 1

Starting Date

Ending Date

Job Duties

Reason For Leaving?

Firm Name

Firm Address

Telephone Number

May We Contact Employer

YES

NO

What Did You Most Enjoy?

What Did You Least Enjoy?

TYPE OF EQUIPMENT USED?

HOW OFTEN ?

WHAT?

Work Experience 2

Starting Date

Ending Date

Job Duties

Reason For Leaving?

Firm Name

Firm Address

Telephone Number

May We Contact Employer

YES

NO

What Did You Most Enjoy?

What Did You Least Enjoy?

TYPE OF EQUIPMENT USED?

HOW OFTEN ?

WHAT?

Work Experience 3

Starting Date

Ending Date

Job Duties

Reason For Leaving?

Firm Name

Firm Address

Telephone Number

May We Contact Employer

YES

NO

What Did You Most Enjoy?

What Did You Least Enjoy?

TYPE OF EQUIPMENT USED?

HOW OFTEN ?

WHAT?

Salary & Future Plans

What's Your Approximate Salary Requirements Per Month?

What Are Your Future Plans?

U.S. Military Record

From

To

Date Of Active Service U.S. Only

From

To

Service Type

Reserved Branch

Active

Inactive Guard

Principal Duties

Additional Information

Through What Channel Was Your Application Made? (EX: In Person - Walk In)

PRIVATE
EXAMPLE: Friend

NAME

ADVERTISEMENT
EXAMPLE: ONLINE

NAME

BUSINESS / PERSONAL REFERENCES

NAME

OCCUPATION

ADDRESS

YEARS KNOWN

Affirmative Action & Consent

Kriger Construction, Inc. Is a government contractor subject to the Vocational Rehabilitation Act of 1973 and Vietnam Era Veterans Readjustment Assistance Act of 1974. Affirmative Action Programs are maintained to promote the employment and advancement of qualified handicapped individuals, Veterans of the Vietnam era and disabled veterans. If you are covered by this program and would like to be considered under the Affirmative Action Program, please tell us by checking the appropriate box below. The submission of this information is voluntary and refusal to provide it will not subject you to adverse treatment. Any such information you provide will be kept confidential and will only be used in accordance with applicable Act regulations.

I wish to be considered under the Affirmative Action Program as:

Handicapped

Vietnam Era Veteran

Disabled

SIGNATURE (Type Full Name) *

DATE *

I have read and agree to all statements above *

Voluntary Additional Applicant Data

Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or disability, or any other legally protected status.

Government agencies at times require periodic reports on the sex, ethnicity, disability, veteran and other protected status of applicants. This data is for analysis and possible affirmative action only. Solely to help us comply with government record keeping, reporting and other legal requirements, we request that you also fill out this section.

This data is for periodic government reporting and will be kept in a confidential file separate from your Application for Employment. YOUR COOPERATION IS VOLUNTARY.

Last Name

First Name

Middle Name

Phone

Address

City

State

Zip Code

Position(s) Applied for

Referral Source:

Friend

Relative

Walk-In

Employment Agency

Other

Check One:

Male

Female

Check One:

White

Black

Hispanic

American Indian/Alaskan Native

Asian/Pacific Islander

Two or More Races

Check if any of the following are applicable:

Vietnam Era Veteran

Disabled Veteran

Other Disabled Individual

Kriger Construction, Inc.

Personal Information

List Prior Addresses Over Past Five Years In Reverse Order

Employment Questions

How did you hear about the employment opportunity?

Travel

Education

Work Experience 1

Work Experience 2

Work Experience 3

Salary & Future Plans

U.S. Military Record

Additional Information

Affirmative Action & Consent

Voluntary Additional Applicant Data

Real Equipment. Real Crews.

Real Environment.