Employment Application Form

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER.
A SMOKE FREE WORK ENVIRONMENT HAS BEEN ESTABLISHED IN ALL FACILITIES.
NOTE: Application form must be completed in its entirety or it will not be valid.

General Information
NAME
* First Name:     * Last Name:     Middle Initial:
OTHER NAMES KNOWN BY:
RESIDENCE
* Street:    * City:    * State:    * Zip:
PHONE NUMBERS
* Day:    Evening:    Cell:   
EMAIL

Application Information
* POSITION

Other:

Shift Preference:     Salary Requirment:
APPLYING FOR:
Full Time     Part Time     Temporary     Seasonal
Employed     or Applied     At HK Systems Before:     Dates:
* HOW WERE YOU REFERRED?:
Newspaper Ad      Company Website      Employee      School      Walk-In
Internet Posting    (please list source):
PLACEMENT AGENCY:

* Record of Education and Training
Schooling Name of School City State Number
of Years
Completed 		Did You Graduate? Diploma
Degree or
Certificate 		Course of Study, Major
High or Preparatory
College or Technical
Graduate School
Business College or Trade

Professional Licenses
Type Certification Number State Year

Skills/Qualifications
List any skills/qualifications which are pertinent to the job for which you are applying for:

* Employment History
May we contact these employers? Yes      No      Yes, but not present employer     
  Present Employer 2 3 4
Name of Company
Address
Supervisor
Supervisor Phone
From Date
To Date
Salary Start
Salary Last
Job Title
Job Description
Reason for Leaving

Miscellaneous
List any organizations, clubs, societies or professional memberships which relate to the job you are applying for:
Military service? Yes      No      If yes:    Branch      Rank
Are you legally eligible for employment in the U.S.? Yes      No
HK Systems uses the E-Verify Employment Verifications System. Federal law requires all employees to verify the identity and employment eligibility of all persons hired to work in the United States.
Have you been convicted of a felony in the last seven (7) years? Yes      No
If “Yes,” please list convictions that are a matter of public record (not arrests). A conviction will not necessarily disqualify you for employment.

Submit
I understand that in the event my application for employment is accepted, the effective date of acceptance and of my employment shall be the time I actually commence work.

If I am employed I agree to comply with all Company rules and regulations. Should I receive an offer of employment, I agree to submit to a drug screening and screenings thereafter consistent with HK Systems’ Policy and the law. I agree to be photographed after employment. I authorize investigation of my background, references, employment record and other matters related to my suitability for employment and do hereby release persons, schools, my current employer (if applicable), former employers and their companies and organizations contacted by HK Systems from any liability for any damage due to releasing information regarding my employment with them, and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts called for on this application is cause for rejection of application and subsequent dismissal from employment. I understand that I will be required to sign confidentiality and code of conduct agreements should I become an employee of HK Systems. I understand that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I understand that completing this form does not indicate there is a position open and does not obligate HK Systems to hire me. I understand that any employment relationship with the Company may be terminated at any time by the Company within its sole discretion for any reason, and that my employment may also be terminated by me at any time and for any reason.

I am available to start work on (date):   
* Enter Security Code to the Right:         5048