I. Personal Information
First Name:
Last Name:
Middle
Present Address:
City:
State:
Zip:
Select a State
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VT - Vermont
WA - Washington
DC - Washington, DC
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Permanent Address:
City:
State:
Zip:
Select a State
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VT - Vermont
WA - Washington
DC - Washington, DC
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Social Security:
Home Phone:
Cellular Phone:
Email Address:
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.
Position Applied for at KANE Construction, Inc:
Select a Position
Project Superintendent
Project Manager
Project Administrative Assistant
Other
1. Is there any information we would need about your name or use of another name for us to be able to check your work record? Please specify:
2. Do you have any relatives who are presently (or have formerly been) employed by KANE Construction, Inc.?
3. How were you referred to KANE Construction, Inc.?
4. Have you ever been convicted of a felony?
Yes
No
If yes, please explain:
II. Educational History
Type of Edcuation
Elementary/ Junior High
High School
College
Technical Training
Other
Type of Edcuation
Elementary/ Junior High
High School
College
Technical Training
Other
Type of Edcuation
Elementary/ Junior High
High School
College
Technical Training
Other
Type of Edcuation
Elementary/ Junior High
High School
College
Technical Training
Other
Type of Edcuation
Elementary/ Junior High
High School
College
Technical Training
Other
III. Employment Record Please include all employment for the last ten (10) years.
1. Company Name (Most Recent Employer):
Position Held:
Address:
Dates Employed:
From
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
-
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Manager / Supervisor:
Telephone:
Wage / Salary:
Reasons For Leaving:
2. Company Name (Most Recent Employer):
Position Held:
Address:
Dates Employed:
From
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
-
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Manager / Supervisor:
Telephone:
Wage / Salary:
Reasons For Leaving:
3. Company Name (Most Recent Employer):
Position Held:
Address:
Dates Employed:
From
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
-
Month
January
February
March
April
May
June
July
August
September
October
November
December
/
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Manager / Supervisor:
Telephone:
Wage / Salary:
Reasons For Leaving:
NOTE: Use a separate sheet to list additional employers, if necessary. We will contact all of the employers listed on this application unless you specifically exclude them below. Please list any employers you do not want us to contact and your reason for the exclusion:
Employer's Name:
Reason:
Employer's Name:
Reason:
IV. References Please do no include relatives or former employers.
1. Reference Name:
Years Known:
Address:
Telephone:
Occupation:
2. Reference Name:
Years Known:
Address:
Telephone:
Occupation:
3. Reference Name:
Years Known:
Address:
Telephone:
Occupation:
V. Work Availability
If your application receives favorable consideration, when will you be available to begin work?
Do you have any objection to working overtime?
Yes
No
Can you work overtime without prior notice?
Yes
No
Can you work on Saturday?
Yes
No
Can you work on Sunday?
Yes
No
Can you travel if required by this position?
Yes
No
VI. Salary / Hourly Rate Requirements
If your application receives favorable consideration, what salary/hourly rate would you require?
$ per
Hour
Year