APPLICATION FOR EMPLOYMENT Use the form below to inquire about employment opportunities with our company. Employee Application Form Position Applying For: Referred By: Your Name (First, Middle, Last): E-mail: Home Phone Number: Cell Phone Number: Street Address: Address Line 2: City: State/Province/Region: South CarolinaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands Zip Code: Have you ever applied to this organization before? YesNo Do you have the legal right to live and work in the U.S.? YesNo Were you referred by someone at King Construction Services, Inc.? YesNo Emergency Contact: Emergency Phone Number: Have you ever been convicted of a felony? YesNo If yes, explain fully below. Conviction of a crime is not an automatic bar to employment – all circumstances will be considered. Do you have a Driver's License? YesNo If yes, please provide Driver's License number. EDUCATION Select the highest grade completed: 123456789101112 College: 1234 List any special skills or equipment you can operate: EMPLOYMENT HISTORY Give employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work. Company Name (Most Recent): Street Address: Address Line 2: City: State/Province/Region: South CarolinaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands Zip Code: Country: United StatesArubaAfghanistanAngolaAnguillaÅland IslandsAlbaniaAndorraUnited Arab EmiratesArgentinaArmeniaAmerican SamoaAntarcticaFrench Southern TerritoriesAntigua and BarbudaAustraliaAustriaAzerbaijanBurundiBelgiumBeninBonaire, Sint Eustatius and SabaBurkina FasoBangladeshBulgariaBahrainBahamasBosnia and HerzegovinaSaint BarthélemyBelarusBelizeBermudaBolivia, Plurinational State ofBrazilBarbadosBrunei DarussalamBhutanBouvet IslandBotswanaCentral African RepublicCanadaCocos (Keeling) IslandsSwitzerlandChileChinaCôte d'IvoireCameroonCongo, the Democratic Republic of theCongoCook IslandsColombiaComorosCape VerdeCosta RicaCubaCuraçaoChristmas IslandCayman IslandsCyprusCzech RepublicGermanyDjiboutiDominicaDenmarkDominican RepublicAlgeriaEcuadorEgyptEritreaWestern SaharaSpainEstoniaEthiopiaFinlandFijiFalkland Islands (Malvinas)FranceFaroe IslandsMicronesia, Federated States ofGabonUnited KingdomGeorgiaGuernseyGhanaGibraltarGuineaGuadeloupeGambiaGuinea-BissauEquatorial GuineaGreeceGrenadaGreenlandGuatemalaFrench GuianaGuamGuyanaHong KongHeard Island and McDonald IslandsHondurasCroatiaHaitiHungaryIndonesiaIsle of ManIndiaBritish Indian Ocean TerritoryIrelandIran, Islamic Republic ofIraqIcelandIsraelItalyJamaicaJerseyJordanJapanKazakhstanKenyaKyrgyzstanCambodiaKiribatiSaint Kitts and NevisKorea, Republic ofKuwaitLao People's Democratic RepublicLebanonLiberiaLibyaSaint LuciaLiechtensteinSri LankaLesothoLithuaniaLuxembourgLatviaMacaoSaint Martin (French part)MoroccoMonacoMoldova, Republic ofMadagascarMaldivesMexicoMarshall IslandsMacedonia, the former Yugoslav Republic ofMaliMaltaMyanmarMontenegroMongoliaNorthern Mariana IslandsMozambiqueMauritaniaMontserratMartiniqueMauritiusMalawiMalaysiaMayotteNamibiaNew CaledoniaNigerNorfolk IslandNigeriaNicaraguaNiueNetherlandsNorwayNepalNauruNew ZealandOmanPakistanPanamaPitcairnPeruPhilippinesPalauPapua New GuineaPolandPuerto RicoKorea, Democratic People's Republic ofPortugalParaguayPalestine, State ofFrench PolynesiaQatarRéunionRomaniaRussian FederationRwandaSaudi ArabiaSudanSenegalSingaporeSouth Georgia and the South Sandwich IslandsSaint Helena, Ascension and Tristan da CunhaSvalbard and Jan MayenSolomon IslandsSierra LeoneEl SalvadorSan MarinoSomaliaSaint Pierre and MiquelonSerbiaSouth SudanSao Tome and PrincipeSurinameSlovakiaSloveniaSwedenSwazilandSint Maarten (Dutch part)SeychellesSyrian Arab RepublicTurks and Caicos IslandsChadTogoThailandTajikistanTokelauTurkmenistanTimor-LesteTongaTrinidad and TobagoTunisiaTurkeyTuvaluTaiwan, Province of ChinaTanzania, United Republic ofUgandaUkraineUnited States Minor Outlying IslandsUruguayUnited StatesUzbekistanHoly See (Vatican City State)Saint Vincent and the GrenadinesVenezuela, Bolivarian Republic ofVirgin Islands, BritishVirgin Islands, U.S.Viet NamVanuatuWallis and FutunaSamoaYemenSouth AfricaZambiaZimbabwe Company's Phone Number: Dates Employed From: To: Job Title: Supervisor's Name and Title: Type of Business: Business Website: Base Rate of Pay (Hour/Week/Month): Start: End: Description of duties: Reason for Leaving: May we contact this employer? YesNo Did you have another job before this one? YesNo ACKNOWLEDGEMENT THIS CERTIFIES THAT I HAVE COMPLETED THIS APPLICATION AND ALL INFORMATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. Drug Testing Consent: My signature indicates that I consent to a mandatory pre-employment drug test. Digital Signature: Printing your First Name + Middle Initial + Last Name will act as your digital signature. Date: KINGS CONSTRUCTION SERVICES, INC. IS AN EQUAL OPPORTUNITY EMPLOYER. It is KINGS CONSTRUCTION SERVICES’ policy to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre-apprenticeship, and/or on-the-job training. All such decisions are based on (1) individual merit, qualifications, and competence as they relate to the particular position, and (2) promotion of the principle of equal employment opportunity. All current employees are encouraged to refer minority and women recruits for employment whenever hiring opportunities are available. KINGS CONSTRUCTION SERVICES, INC. IS ENROLLED IN E-VERIFY! Resume Upload (optional): If you have a resume you'd like to attach, please do so here. This is not required. EQUAL EMPLOYMENT OPPORTUNITY DATA REPORTING FORM Today's Date Today's Date: First Name: Middle Name: Last Name: Gender (Please check appropriate box): MaleFemale Date of Birth: Race (Please check appropriate box): White, not of Hispanic OriginBlack or African American, not of Hispanic OriginHispanic or LatinoAsian, not Hispanic or LatinoNative Hawaiian or Other Pacific Islander, not Hispanic or LatinoAmerican Indian or Alaskan NativeTwo or more races, not Hispanic or Latino How did you hear about King Construction Service, Inc.? WebsiteEmployeeAsphalt Works CampaignProject SiteFriendOther Like