application for employment - kemco industries（申请就业u2014u2014kemco产业）.pdf

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