17108 County Line Road
Union Grove, WI 53182

APPLICATION FOR EMPLOYMENT

Willkomm Excavating & Grading, Inc. is an equal employment opportunity employer dedicated to a policy of nondiscrimination in employment based upon an individual’s race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, or the presence of any non-job-related medical condition or disability. In reading and answering the following questions, please keep in mind that none of the questions are intended to imply any limitations, illegal preferences, or discrimination based upon any non-job-related information. This application will be given consideration, but its receipt does not imply that the applicant will be interviewed or employed.

Personal Info

General Info

  1. Have you ever applied for a job with this company in the past? If yes, please give the date of application and position for which you applied. State your name at that time, if different from present time.

  2. Have you ever been employed by this company in the past? If yes please give dates of employment, position held, and state your name while employed if different from present name.

  3. If hired, will you be able to work during the normal days and hours required for the position(s) for which you are applying? If no, please explain:

  4. Do you have any commitments to another employer that might affect your employment with our company? If yes, please explain:

School Info

High School

Technical, Vocational Business, or Military Training

Graduate School

Professional Seminars

Additional JOB-RELATED seminars, short courses, workshops, or other educational experiences:

JOB-RELATED certificates, licenses, equipment qualified to operate, computer hardware and software operated, and other JOB-RELATED special skills and abilities:

Employment History

PRESENT & FORMER EMPLOYERS (List Present or Most Recent First)

Please account for any time you were not employed after leaving school in the past ten years (you need not list any unemployment periods of one month or less)


References


OTHER JOB-RELATED EXPERIENCE. Some people gain job-related experience in positions other than as an employee. For instance, an accountant may gain experience as a treasurer of a civic or school organization, or a manager may gain experience while working on civil projects or in school organization or in PTA Activities. Please list and describe any paid or unpaid activities, honors, experience, or training that might aid you in performing the job (s) for which you have applied, and have not been listed previously in this application. (you may omit any activities, honors, memberships, or other items that tend to identify your race, sex, national origin, age, disability, or other personal traits that you prefer not to disclose.)

Please add any additional information (except that which identifies your race, sex, age, religion, national origin, disability or other non-job-related personal information) that you think may be relevant to a decision to hire you.

Willkomm’s Equal Employment Opportunity Policy

Willkomm Excavating & Grading, Inc. (“Willkomm”) is an equal employment opportunity employer. Willkomm adheres to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Willkomm depends solely on your qualifications:

It is our policy to provide equal employment opportunity to all qualified individuals without regard to their race, color, religion, national origin, age or sex in all personnel actions including recruitment, evaluation, selection, promotion, compensation, training and termination.

It is our policy to promote equal employment opportunity through a positive, continuing program of specific practices designed to ensure the full realization of equal employment opportunity without regard to race, color, religion, national origin, age or sex.

It is our policy to communicate our equal employment policy and employment needs to sources of qualified applicants, without regard to race, color, religion, national origin, age or sex, and to solicit their recruitment assistance on a continuing basis.

It is our policy to continually review our job structure and employment practices and maintain positive recruitment training, job design and other measures needed to ensure genuine equality of opportunity at all levels.

It is our policy to conduct a continuing program to exclude all unlawful forms of prejudice or discrimination based upon race, color, religion, national origin, age or sex from our personnel policies and practices and working conditions.

IMPORTANT, PLEASE READ THE FOLLOWING, CAREFULLY:

I certify that all the information I provided on this employment application is accurate and complete to the best of my knowledge. And I understand that any misleading statement or false statement will constitute sufficient cause for refusal of hire or termination of my employment.

I understand that neither the acceptance of this employment application nor the subsequent entry into any type of employment relationship with Willkomm Excavating & Grading, Inc. (“Willkomm”) will create an actual employment contract or an implied employment contract.

I understand that if I accept a Willkomm conditional employment offer, such employment will be on an at-will basis — I understand that this means that either I or Willkomm have the right to terminate this employment relationship at any time, for any reason, and with or without cause.

Upon receiving and accepting Willkomm’s conditional employment offer, and only if Willkomm extends such offer, I acknowledge that I may be required to submit to drug testing, alcohol testing, or a medical examination, and I agree to submit to such testing or examination. I release Willkomm, Willkomm’s employees, and Willkomm’s agents from any-and-all liability arising out of or related, in any way, to such testing or examination.

I understand that if I accept a Willkomm’s conditional employment offer, I may not hold other employment.

I understand that if I accept Willkomm’s conditional employment offer, I may not engage in any sale, investment, or any other activity that will create a conflict of interest with Willkomm.

I understand that if I accept Willkomm’s conditional employment offer, I am required to immediately disclose, to Willkomm, any activity or event, on my part, that may adversely affect Willkomm or my position or employment at Willkomm.

Certification Dates

Check the certifications and enter the date you have acquired them.

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