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About You

First Name

Last Name

Address Line 1

Address Line 2

City

State

ZIP

Email Address

Phone Number

Position you are applying for:

Upload Resume (PDF)

Maximum 7 MB

Have you ever been employed with Kondex before? Yes No

Are you currently employed? Yes No

If so, may we contact your present employer? Yes No

Are you legally authorized to work in the U.S.? (If hired, you will be required to provide proof of work authorization.) Yes No

Are you 18 years or older? Yes No

Shift preference

1st shift

2nd shift

3rd shift

Weekend shift

Shifts you are willing to work

1st shift

2nd shift

3rd shift

Weekend shift

Hours preference

Full-time

Part-time

Seasonal

If “Part-time,” what hours would you like to work?

If “Seasonal,” what timeframe would you like to work?

What are your pay requirements?

Other

If a Kondex associate referred you, who was it?

Employment History

I have no prior employment.

Please see my attached resume and cover letter.

Please list your most recent employer first.

Employer #1

Company

Name of Supervisor

Phone Number

Address Line 1

Address Line 2

City

State

ZIP

Employment Start (month/year)

Employment End (month/year)

Type of Work Performed

Salary

Reason for Leaving

Employer #2

Company

Name of Supervisor

Phone Number

Address Line 1

Address Line 2

City

State

ZIP

Employment Start (month/year)

Employment End (month/year)

Type of Work Performed

Salary

Reason for Leaving

Employer #3

Company

Name of Supervisor

Phone Number

Address Line 1

Address Line 2

City

State

ZIP

Type of Work Performed

Employment Start (month/year)

Employment End (month/year)

Salary

Reason for Leaving

Employer #4

Company

Name of Supervisor

Phone Number

Address Line 1

Address Line 2

City

State

ZIP

Employment Start (month/year)

Employment End (month/year)

Type of Work Performed

Salary

Reason for Leaving

All Employment

Please summarize special skills and qualifications acquired from employment or other experience.

Education

Please see my attached resume and cover letter.

High School

Name of School

Address Line 1

Address Line 2

City

State

ZIP

Phone Number

Years Attended

Diploma received? Yes No

College or Technical School

Name of School

Address Line 1

Address Line 2

City

State

ZIP

Phone Number

Years Attended

Major(s)

Diploma/degree received? Yes No

Signature

I certify that the answers given by me to the foregoing questions and statements are true and correct without consequential omissions of any kind. I agree that the company shall not be held liable in any respect if my employment is terminated because of false statements, answers or omissions made by me in this application. I understand that any misleading or incorrect statements may render this application void, and if employed, may be cause for termination. I understand that a drug screen will be required as part of the pre-employment process. I also authorize the companies, schools or persons from all liability for any damage for issuing this information. In consideration of my employment, I agree to conform to the rules and regulations of this organization. My employment can be terminated with or without notice, at any time, at the option of either my employer or myself.

Digital Signature

I certify