240 Levee Drive - Manhattan, KS 66502

(785) 776-3530 | appletechdc@yahoo.com

Employment Application

APPLICATION FOR EMPLOYMENT

"Drug Free Workplace"

APPLETECH DESIGN & CONSTRUCTION, INC. IS AN EQUAL OPPORTUNITY EMPLOYER. We are committed to the policy of equal employment opportunity in recruitment, hiring, career advancement and all other personnel practices. Your job-related experience and other qualifications will be considered without discrimination on grounds of race, sex, disability, religion, age, color, national origin or ancestry, or other factors which cannot be lawfully used as basis for an employment decision. All other information provided in this application will be treated confidentially, and will be used only to help assure the best use of your abilities if you are employed by us.

PERSONAL DATA

Name

Date

Other Names Ever Used

Present Address

City

Zip

Telephone Number

Email

Are you over age 18?

Have you ever been convicted of a felony within the past five years? (Include military convictions)

If yes, please explain where, when and reason

If employed, can you provide proof of U.S. citizenship, immigration, or visa status which permits you to be employed in the U.S.?

Do you have reliable transportation?

Is your driver's license currently suspended or revoked?

If so, state reason for suspension.

EMPLOYMENT INFORMATION

Position(s) applying for

Date available to begin work

Are you applying for full time or part time employment?

What hourly rate do you expect to get paid?

Check the position which you feel most qualified for

How long do you anticipate being available for employment by Appletech?

Have you ever been responsible for directing or supervising other employees? If so, please explain.

EDUCATION/TRAINING

What is the highest grade level you have completed in school?

High School Diploma or G.E.D.?

Give the following information about the schools you have attended

School Name & Location Degree Course of Study/Major

High School

Business/Trade School

College/University

List or describe any school or specialized training that relate to the position for which you are applying

EMPLOYMENT HISTORY

Beginning with your present job (or immediate past job if unemployed) list your employment for the last 5 years

Employment History #1

Company

Position

Address

Phone

Date Started

Date Ended

Type of Work

Rate of Pay

Supervisor's name and title

Reason for Leaving

Employment History #2

Company

Position

Address

Phone

Date Started

Date Ended

Type of Work

Rate of Pay

Supervisor's name and title

Reason for Leaving

Employment History #3

Company

Position

Address

Phone

Date Started

Date Ended

Type of Work

Rate of Pay

Supervisor's name and title

Reason for Leaving

Employment History #4

Company

Position

Address

Phone

Date Started

Date Ended

Type of Work

Rate of Pay

Supervisor's name and title

Reason for Leaving

READ THIS APPLICATION AND YOUR ANSWERS CAREFULLY BEFORE SUBMITTING YOUR APPLICATION

I hereby certify that all the statements contained here are true to the best of my knowledge and I understand that omissions or misstatements may be used for rejection of this application, removal of my name from eligibility, or discharge from service. I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision. I understand that, if hired, my employment will be "at-will" and could be terminated at any time by either party, with or without cause and with or without notice. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If employed by Appletech Design & Construction, Inc., I agree to abide by its rules and regulations. I understand that Appletech Design & Construction has a drug and alcohol policy that provides for pre-employment testing as well as testing after being employed. I understand that consent to and compliance with the policy is a condition of my employment and that continued employment is based on the successful passing of testing under the policy.

I have read and understand the above information.