Employment Application

Employment Application

KC Restoration is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the Human Resource Representative.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.

Full Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Confirmation Email

Position you are applying for

Restoration TechnicianRestoration Technician TraineeOther

Wage expectations*

Salary or Hourly?*

Referral source

List the name of any relatives or friends currently working at or who has previously worked at KC Restoration

Are you over the age of 18?*

YESNO

Are you eligible to work in the United States without sponsorship (if hired, you will be required to show proof of citizenship)?*

YESNO

Are you fluent in a foreign language?*

YESNO

If yes, what language(s)?

Are you currently employed?*

YESNO

Date available for work*

MonthDayYear

Some positions may require the ability to work a combination of days, night and occasional weekends. Please check all shifts below that you would be available and willing to work.*

Full timePart timeNightsWeekends

Our Technician positions do require the ability to do shift work. Are you able to perform shift work (a combination of days and nights and occasional weekends)?*

YESNON/A; I am not applying for a Technician position

Are you able to perform the “essential functions” of the job for which you are applying (with or without reasonable accommodation)?*

YesNoNeed more information on the essential job duties

Have you applied here before?*

YESNO

EDUCATION

Highest level of education completed:*

Please complete the appropriate sections

	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your three most recent employers, list the most recent first

1. Employer

Employer's Name (Most current)*

Address or location of business*

Your title*

May we contact this employer?*

YESNO

Supervisor's name*

First and Last Name

Supervisor's Phone number

Area CodePhone Number

Supervisor's Email

example@example.com

Start date*

MonthDayYear

End date

MonthDayYear

Wages START:*

Wages END:*

Work performed:*

Reason for leaving*

2. Employer

Employer's Name (Second most recent)*

Address or location of business*

Your title*

May we contact this employer?*

YESNO

Supervisor's name*

First and Last Name

Supervisor's Phone number

Area CodePhone Number

Supervisor's Email

example@example.com

Start date*

MonthDayYear

End date

MonthDayYear

Wages START:*

Wages END:*

Work performed:*

Reason for leaving*

3. Employer

Employer's Name (Third most recent)

Address & location of business

Your title

May we contact this employer?

YESNO

Supervisor's name

First and Last Name

Supervisor's Phone number

Area CodePhone Number

Supervisor's Email

example@example.com

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Wages END:

Work performed:

Reason for leaving

ADDITIONAL INFORMATION

If you are applying for the Technician position, check the boxes of the following essential functions of the job you would be able to perform.

List any skills that may be useful for the job you are seeking:

Do you have a U.S. military service record?*

YESNO

If yes, branch of service*

REFERENCES

List three professional references, (business or work, not relatives) that you have known for at least one year.

1. Full Name*

First NameLast Name

Company

Best phone number to reach them

Area CodePhone Number

Email*

example@example.com

Years acquainted*

Relationship*

2. Full Name*

First NameLast Name

Company

Best phone number to reach them*

Area CodePhone Number

Email*

example@example.com

Years acquainted*

Relationship*

3. Full Name*

First NameLast Name

Company

Best phone number to reach them

Area CodePhone Number

Email*

example@example.com

Years acquainted*

Relationship*

AUTHORIZATION

I understand that KC Restoration is making no employment offer at this time. I certify that the information in this application is correct to the best of my knowledge. I understand that any misrepresentation or omission of any fact in my application, resume, or any other materials, or during interviews is grounds for disqualification from further consideration for employment or for termination, if employed.

I authorize KC Restoration to contact any company, institution, or individual it deems appropriate to investigate my employment history, character, qualifications, credit history, driving record, and other relevant information, if job-related. I give my full consent for all contacted individuals, including former employers, to provide information concerning this application, and I waive my right to bring any cause of action against these individuals for any and all liability for damages arising from furnishing the requested information to KC Restoration. I acknowledge that a facsimile and/or photocopy of this form is as valid as the original.

KC Restoration provides pre-employment testing (drug testing, background checks, motor vehicle checks). I understand that any offer of employment may be withdrawn if drug tests are positive, if there is falsification of information given and/or if a condition is discovered for which no reasonable accommodation can be made.

I understand that this application is current for 60 days. At the conclusion of this time, if I have not heard from KC Restoration and still wish to be considered for employment, it will be necessary to complete a new application.

I understand that if hired, employment is at-will, regardless of the employer, and may be terminated by myself, the employer at any time, with or without cause or notice, for any reason or no reason. Moreover, no agent, representative, or employee of KC Restoration, except in a specific written contract of employment signed on behalf of the organization by its CEO, has the power to alter or vary the voluntary nature of the employment relationship.

By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree

You must agree to accept the terms of the document in order to submit an application.

Type signature*

Date*

MonthDayYear

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