McKiness Excavating Employment Application

WE ARE AN EQUAL OPPORTUNITY EMPLOYMENT COMPANY. WE ARE DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, CREED, COLOR, AGE, SEX, RELIGION, NATIONAL ORIGIN, OR PHYSICAL DEFECTS. THIS APPLICATION MUST BE FILLED OUT COMPLETELY.

If you wish to submit a resume, please email it to office@mckiness.com. If you experience issues while submitting the application, you may also use this link.

Website (leave blank)

Company (do not fill)

Personal Information

Phone Number

First Name

Middle Name

Last Name

Present Address - Street

City

State

Zip

Referred By

Employment Desired

Employment Type

Full Time Part Time Full Time (summer only)

Position Desired Start Date Desired Hourly Wage Currently Employed?

Yes No

If yes, may we inquire with your present employer?

Yes No

Have you previously applied to this company before?

Yes No

If yes, when?

Education

URL (leave empty)

High School (Name, Location, Year Graduated, Relevant Subjects) College (Name, Location, Year Graduated, Relevant Subjects) Trade/Business School (Name, Location, Year Graduated, Relevant Subjects) Subjects of Special Study or Research Work U.S. Military or Naval Service

Yes No

Present Membership in National Guard or Reserve

Yes No

Activities other than religious, civic, athletic, fraternal, etc _{Do not include organizations, the name or character of which indicates the race, creed, color or national origin of its members.} Have you been convicted of a crime in the past ten years excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court? If yes, please describe in full.

Former Employers

_{List up to four previous employers starting with the most current.} Employer #1 Name and Address Date Range Employed Position and Salary Reason for Leaving Employer #2 Name and Address Date Range Employed Position and Salary Reason for Leaving Employer #3 Name and Address Date Range Employed Position and Salary Reason for Leaving Employer #4 Name and Address Date Range Employed Position and Salary Reason for Leaving

References

_{Give the names of two persons not related to you whom you have known at least one year. Should be connected to work or knows of your work.} Reference #1 (Name, Phone, City, State, Business, Years Acquainted) Reference #2 (Name, Phone, City, State, Business, Years Acquainted)

Experience

_{No one will be considered who does not show experience/qualifications completely. Show machines operated, labor performed, trucks driven, number of years, and for whom.} Carpenters, Cement Mason, Steel Worker (Types of construction, years, and companies) Laborer (Tasks performed, years, and companies) Operators (Machines operated, years, and companies) Truck Drivers (Trucks driven, years, and companies)

Driver Information

Do you have a state of Iowa driver's license?

Yes No

Driver's License Number Do you have a CDL license?

Yes No

If yes, what class? _{CLASS A: Vehicle Gross Weight of 26,001 lbs. or more and towed unit is 10001 lbs or more. CLASS B: Vehicle Gross Weight of 26,001 lbs. or more and towed unit is less than 10001 lbs. CLASS C: Vehicle Gross Weight is less than 26,001 lbs.} Are you on SR-22 insurance?

Yes No

Have you ever been on SR-22?

Yes No

If yes, when?

Additional

Job Foreman or Superintendent (Project types/sizes, people managed, years, companies) _{Please include types and sizes of projects, number of people under your supervision, number of years, and company names.} Other job-related responsibilities experienced in the past Are you a U.S. citizen?

Yes No

Years in State Have you read the job descriptions? Job Descriptions

Yes No

Are you willing to take a drug test?

Yes No

Is there anything physically or mentally that would prevent you from performing the described tasks? Job Descriptions

Yes No

If yes, please explain If no, are you willing to take a functional capacity evaluation and/or fitness for duty exam?

Yes No

APPLICANT PLEASE READ CAREFULLY PLEASE ANSWER ALL THE QUESTIONS ON THIS FORM TO THE BEST OF YOUR ABILITY. YOUR QUALIFICATIONS WILL BE CAREFULLY REVIEWED AND YOU WILL BE GIVEN THOROUGH CONSIDERATION FOR ANY SUITABLE VACANCIES IN THE COMPANY. IF YOU ARE EMPLOYED, THIS WILL BECOME PART OF YOUR PERMANENT PERSONNEL RECORD. WE APPRECIATE YOUR INTEREST AS SHOWN BY YOUR FILLING OUT THIS APPLICATION FORM. I HEREBY AFFIRM AND DECLARE THAT ALL THE FOREGOING STATEMENTS ARE TRUE AND CORRECT, AND THAT I HAVE NOT KNOWINGLY WITHHELD ANY FACT THAT WOULD, IF DISCLOSED, AFFECT MY APPLICATION UNFAVORABLY. I HEREBY AUTHORIZE THE COMPANY TO CONDUCT ANY INVESTIGATION TOGETHER WITH THEIR OPINIONS ON THESE MATTERS WITHOUT ANY LIABILITY FOR ANY DAMAGE WHATSOEVER CAUSED EITHER DIRECTLY OR INDIRECTLY BY GIVING OR RECEIVING THIS INFORMATION OR OPINIONS. THE INVESTIGATIONS WILL INCLUDE BUT ARE NOT LIMITED TO RUNNING MOTOR VEHICLE REPORTS ON THE APPLICANT TO DETERMINE THEIR DRIVING RECORD AND DRIVING INSURABILITY. I AUTHORIZE MY FORMER AND PRESENT EMPLOYERS AND PERSONAL REFERENCES TO GIVE ANY INFORMATION THEY MAY HAVE CONCERNING MY CHARACTER, HEALTH AND EMPLOYMENT RECORD. IT IS UNDERSTOOD THAT A FALSE STATEMENT ON THIS APPLICATION MAY BE CONSIDERED A SUFFICIENT CAUSE FOR REJECTION OF THIS APPLICATION, OR DISMISSAL, IF ALREADY EMPLOYED BY THE COMPANY. IN OUR ONGOING EFFORT TO MAINTAIN A DRUG FREE WORK-PLACE, WE REQUIRE A VALID, NEGATIVE DRUG TEST AS A CONDITION OF EMPLOYMENT. FOR THIS TEST, YOU WILL BE ASKED TO PRODUCE AT LEAST 1/4 CUP OF URINE. PLEASE REMEMBER NOT TO URINATE WITHIN 1 HOUR BEFORE YOUR TEST AND DRINK NO MORE THAN 2 TO 3 CUPS OF LIQUID BEFORE THE TEST. ALSO, YOU WILL BE REQUIRED TO SUPPLY THE COLLECTION SITE WITH A PICTURE ID. ANY ATTEMPT TO DILUTE, SUBSTITUTE, OR CONTAMINATE YOUR SPECIMEN WILL RESULT IN AN INVALID TEST. THIS WILL PREVENT EMPLOYMENT WITH THIS COMPANY. BY SUBMITTING BELOW YOU AGREE TO PARTAKE IN PRE-EMPLOYMENT DRUG TESTING AND YOU AGREE TO ALLOW THE COMPANY TO RUN AND REVIEW THE APPROPRIATE MOTOR VEHICLE REPORTS. ANY OFFER OF EMPLOYMENT WILL BE CONTINGENT ON PASSING THE PRE-EMPLOYMENT DRUG TEST AND HAVING A SATISFACTORY MOTOR VEHICLE REPORT. YOU ALSO AGREE TO A PRE-EMPLOYMENT FUNCTIONAL CAPACITY EVALUATION AND OR FITNESS FOR DUTY EXAM. If you wish to submit a resume, please email it to office@mckiness.com

I have read and agree to the terms above