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application for employment - kemco industries(申请就业u2014u2014kemco产业)
Application for Employment
Pre-Employment Questionnaire
Kemco Industries, Inc.
An Equal Opportunity Employer
Kemco Industries, Inc. is an equal opportunity employer and its policy is to fill every position without regard to race, religious creed, color,
national origin, ancestry, age, physical disability, mental disability, medical condition, marital status, sexual orientation, sex or other
considerations made unlawful under state or local laws.
Date of Application _________________
Personal Information
Name (Last Name, First) Social Security Number
Present Address City State Zip Code
Permanent Address City State Zip Code
Phone No. Referred By
In case of Emergency Notify:
Name _________________________________________ Phone ________________________
Address ______________________________________________________________________
Employment Desired
Position Desired Date you can Start Salary Desired
Are you employed? If so may we inquire of your present employer?
Yes _____ No ______ Yes _____ No ______
Ever Applied for a position with Kemco Industries, Inc. Where? When?
Before?
Yes _____ No ______
Employment Eligibility
Are you prevented from lawfully becoming employed in this country because of Visa or
Immigration Status? Yes___ No ___
Are you over 18 years of age? _____If hired, can you show proof of age? ______
Are you capable of performing in a reasonable manner the essential dut
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