KALCO CORPORATION EMPLOYEMENT APPLICATION Position Applied ForEMPLOYEE INFORMATIONName *FirstMiddleLastTelephone *Alternate telephoneEmail *Address:Are you able to prform the essential functions of the position with or without to accommodations?YesNoIf necessary for the job are you older than:141516181921(Check one)I am legally elegible for employment in US?YesNoI am seeking a permanent position:Yes NoI will be able to report to workdays after being notified i am hiredIf necessary for the job, I am able to:Work overtime?YesNoProvide a valid Drivers License?Yes NoIf so, fill out the following: Issuing state:Type:Endorsement(s): Hazardous MaterialPassengersTankersThank with Hazardous MaterialScool Bus Double/Triple trailersWork the following shifts: (check all that apply)Any DayNight Swing RotatingSplitGraveyardOther:EMPLOYMENT HISTORYList most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 year history recommended.Employer name and addressPosition title/duties, skills:Reason for leaving:Pay:Per:Start date:End date:Supervisor:Supervisor Telephone:----------------------------------------------------------------Employer name and addressPosition title/duties, skills:Reason for leaving:Pay:Per:Start date:End date:Supervisor:Supervisor Telephone:----------------------------------------------------------------Employer name and address:Position title/duties, skills:Reason for leaving:Pay:Per:Start date:End date:Supervisor:Supervisor Telephone:----------------------------------------------------------------Employer name and address:Position title/duties, skills:Reason for leaving:Pay:Per:Start date:End date:Supervisor:Supervisor Telephone:Summarize other employment related to this job:EDUCATIONHigh schoolInstitution nameYears completedGraduate or degreeField of studyCollege / UniversityInstitution nameYears completedGraduate or degreeField of studyBusiness / TechnicalInstitution nameYears completedGraduate or degreeField of studyAdditionalInstitution nameYears completedGraduate or degreeField of studyMILITARYAre you a veteran?YesNoDuty / specialized training:SKILLS & QUALIFICATIONSOther qualifications such as special skills, abilities or honors that should be considered:Types of computers, software, and other equipment you are qualified to operate or repair:Professional licenses, certifications or registrations:Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employer's attention:Typing speed:per minuteREFERENCESList two personal references who are no relatives or former supervisor.NameAddressTelephoneOccupationYears knownNameAddressTelephoneOccupationYears knownCONTACTIn case of accident or illness, please contact:Name:Daytime phone:Address:Relationship:INFORMATION TO THE APPLICANTAs part of our procedure for processing your employment application, your personal employment references may be checked. If you have misrepresented or omitted facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its terms.I accept *I understand and agree to the information show aboveEqual Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purpose only. This information is optional and failure to provide it will have no effect on your application for employment.CommentSend