Job Application

PERSONAL: (Please print all information requested)
Name*
First Middle Last
Date*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position Sought*
Full Time or Part Time?*
- Full Time
- Part Time
Date Available*
MM slash DD slash YYYY
Salary Desired*
Phone*
If under 18, please list age
Are you legally eligible for employment in the United States? (If offered employment, you will be required to provide documentation to verify eligibility.)*
- Yes
- No

EMPLOYMENT: List last employer first
May we contact your present employer?
- Yes
- No
Employer name and telephone numbers are mandatory.
Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Position
Dates of Employment:
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Salary
Supervisor
First Last
Job Title
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Reason for Leaving (be specific)
Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone
Position
Dates of Employment:
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Salary
Supervisor
First Last
Job Title
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Reason for Leaving (be specific)
If you wish to describe additional work experience, use the space below to summarize any information necessary to describe your full qualifications for the specific position for which you are applying:
Explain any gaps in work history:
Did you complete this application yourself?
- Yes
- No
If not, who did?
Have you ever been employed in any facility of KEMPER CONSTRUCTION LLC?
- Yes
- No
If so, please state facility name and location and dates of employment:

APPLICANT'S CERTIFICATION AND AGREEMENT

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize KEMPER CONSTRUCTION LLC to verify their accuracy and to obtain reference information on my work performance. I hereby release KEMPER CONSTUCTION LLC from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I also understand that (1), KEMPER CONSTRUCTION LLC has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment: (2) consent to and compliance with such policy is a condition of my employment: and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations. As a condition for my application being considered, and/or being hired, I understand and agree to undergo random substance (any illegal drug) screening at any given time of my employment. I understand that if my test results are positive, this is reason for immediate dismissal and I will not be considered for further employment.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.
Applicant's Signature (print)*
Date*
MM slash DD slash YYYY

Online Job Application Form

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