Employment Application Applicant InformationName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Phone*Email* Date Available Desired Salary Position you are applying for Have you ever filed an application with us before? Yes No Are you currently employed? Yes No May we contact your present employer? Yes No Best time to contact you at home is: Are you a citizen of the United States?* Yes No Are you authorized to work in the U.S.?* Yes No Have you ever worked for this company? Yes No When did you work for us? Do any of your friends/relatives work here? Yes No Please state name and relationship: Do you have a valid Driver’s License?* Yes No EducationName and Address of High School Years Completed Did you graduate? Yes No Name and Address of College Years Completed Degree Name and Address of Other Education Years Completed Degree/Certification Personal/Professional ReferencesName First Last PhoneOccupation Name First Last PhoneOccupation Name First Last PhoneOccupation Work ExperienceEmployer PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Supervisor First Last Job Title Work Performed Start/End Dates Reason for Leaving May we contact your previous employer for a reference? Yes No Employer PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Supervisor First Last Job Title Work Performed Start/End Dates Reason for Leaving May we contact your previous employer for a reference? Yes No Comments: Include any explanation of gaps in employmentDescribe any specialized training, or job-related training that you feel would benefit this company:Supplemental Application1. Stutzman & Kropf Contractors is a people business with customer service and satisfaction as one of its primary goals. How do you feel you can contribute to our goals?2. Why do you want this job and how does it fit into your future plans?3. What did you like best about your last job?4. What did you like least about your last job?5. Think back to the supervisors that you have had in the past. Which one did you like the best and why?6. Which supervisor did you dislike, and why?7. Who is primarily responsible for your safety?8. Why do you feel you can handle a job with our company?9. What do you think should be done about an employee who is not doing their fair share of work?10. If you were faced with a disgruntled customer, how would you handle the situation?Applicant StatementConsent* I agree to this statementI certify that my answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive or this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all ruled and regulations of the employer. I understand that after being offered a job. The commencement of my employment will be conditioned on the satisfactory results of an employment entrance examination which includes a drug screen and medical examination. I further understand that I will be subject to future medical exams and drug and alcohol screening when requested by Stutzman & Kropf Contractors, Inc. I understand this form does not indicate that there are any positions open at this time and does not in any way obligate the company. Δ
