| Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, or handicap. We are an equal opportunity employer. Items marked by an * are required. |
| Personal |
| Date*: |
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| Last Name*: |
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| First Name*: |
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| Middle Initial: |
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| Address*: |
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| Address 2: |
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| City*: |
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| State*: |
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| Zip*: |
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| Home Phone*: |
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| Business Phone*: |
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| What was your previous address*? |
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| How long at present address*: |
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Are you over 18 years of age
(if not, employment is subject to verificaton of minimum legal age.)* |
yes
no |
| Have you ever applied for employment with us? |
yes no |
| If yes, Month and Year;* |
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| How did you hear about Kincaid Industries Inc.? * |
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| Are you legally eligible for employment in the U.S.? |
yes
no |
| When will you be able to work?* |
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| Are you employed now?* |
yes
no |
| If so, may we inquire of your present employer? |
yes
no |
| Position Desired:* |
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| Have you ever been convicted of a crime in the past 10 years, excluding misdemeanors and summary offenses, which has not been annuled, expunged or sealed by a court?* |
yes no |
| If yes, please explain: |
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| Are there any reasons for which you might not be able to perform the job duties normally expected of a plumber (with a reasonable accomodation)?* |
yes no |
| If yes, please explain: |
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| Driver's License#: * |
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| State Issued: * |
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| Any Violations: * |
yes
no |
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