Key Construction is an equal opportunity employer committed to a policy of nondiscrimination with respect to race, color, religion, gender, national origin, disability, age, pregnancy, Vietnam veteran status, and any other class protected by applicable federal, state or local law.
Name (Last, First)
Email Address
Street Address / Apt. #
City
State
Zip Code
Home Phone
Are you authorized to work in the United States?
 YES NO
Are you over the age of 18?
 YES NO
Are you able to meet the attendance requirements of the position?
 YES NO
Will you work overtime if required?
 YES NO
Social Security No.
Date available for work
Drivers License No. (If required for position)

Type of Work desired
Pay desired

List all employment for the past five years, starting with the most recent or present employer. If necessary, attach a separate sheet of paper with additional information. Resumes should not be substituted for completing this employment record.
Employer #1
Nature of Employment
Length of Employment
Start End
Total
Years Months
Address
City
Phone
Your Title
Supervisor
Supervisor's Title
Principal Responsibilities (Be complete and specific)
Reason for leaving
May we contact them for a reference?
 YES NO
Employer #2
Nature of Employment
Length of Employment
Start End
Total
Years Months
Address
City
Phone
Your Title
Supervisor
Supervisor's Title
Principal Responsibilities (Be complete and specific)
Reason for leaving
May we contact them for a reference?
 YES NO
 
Employer #3
Nature of Employment
Length of Employment
Start End
Total
Years Months
Address
City
Phone
Your Title
Supervisor
Supervisor's Title
Principal Responsibilities (Be complete and specific)
Reason for leaving
May we contact them for a reference?
 YES NO
 
Employer #4
Nature of Employment
Length of Employment
Start End
Total
Years Months
Address
City
Phone
Your Title
Supervisor
Supervisor's Title
Principal Responsibilities (Be complete and specific)
Reason for leaving
May we contact them for a reference?
 YES NO
 
During the past five years, have you had any periods of unemployment?
 YES NO
If yes, when?
May we contact your current employer?
 YES NO
If not, specify reason.
During the past five years, have you ever been discharged, suspended or asked to resign for any reason from any position?
 YES NO
If yes, please explain.
For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the organizations you have listed?
 YES NO
If yes, please explain.
Within the past seven years, have you been convicted of a crime other than misdemeanor or traffic violations?*
 YES NO
If yes, please explain.
*Having a criminal record, other than misdemeanor traffic violations, does not necessarily mean you will be denied employment.

High School
City/State
Years Completed
Graduated
 YES NO
Course of Study
 
College
City/State
Years Completed
Graduated
 YES NO
Course of Study
 
Vocational or Trade School
City/State
Years Completed
Graduated
 YES NO
Course of Study
 
Other
City/State
Years Completed
Graduated
 YES NO
Course of Study

List names and phone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list school or personal references not related to you.
Name
Telephone
Years Known
 
Name
Telephone
Years Known
 
Name
Telephone
Years Known
   
   

I hearby certify that the information given by me is true in all respects. I authorize Key Construction and its representatives to contact my current and prior employers and all persons and entities for the purpose of verification of the information I have supplied, and I hereby release Key Construction and those persons and entities from any liability resulting from the information released. I authorize employers, schools and other persons named on this application to provide any information or transcripts requested. I understand that misrepresentation or omission of facts by me are grounds for refusal to hire me or my termination of employment.

I understand that a condition of employment with Key Construction is my participating in a urine test for illicit drugs and/or alcohol. I further understand that failure to consent to this test, or a positive test, will be considered a withdrawal of any conditional offer of employment. I also consent to testing for illicit drugs and/or alcohol while employed by Key Construction.

I hereby give my consent to a pre-employment physical and alcohol/drug screen test, and that the results will be released to the Human Resources Department at Key Construction.

Employment with Key Construction is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

In the event that I am employed by Key Construction, I understand that I must comply with all company policies and rules.

I acknowledge and agree that my employment and compensation can be modified or terminated at any time with or without cause and with or without notice at the option of either Key Construction, or me. I understand that no representative of Key Construction, other than the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing, either before or commencement of employment or after I have become employed, and such agreement must be in writing and signed by the President.
I AGREE WITH THE ABOVE STATEMENTS.