Application for Employment

Your Current Address

1. Please indicate your gender:
2. ***Please indicate if you are either Hispanic or Latino: (if yes please skip to question #4)
3. Please indicate which of the following categories best describes your race but not including Hispanic or Latino (*** If yes to #2 then please skip this question and go to #4):
4. Are you entitled to or are receiving disability benefits under laws administered by the Veterans Administration for a disability of 30% or more, or have you been discharged or released from active military duty for a disability incurred or aggravated in the line of duty?
5. Did you serve on active duty in the U.S. Armed forces for a period of more than 180 days, any portion of which occurred between August 5, 1964 and May 7, 1975?
6. Do you have a physical, mental, or emotional impairment which substantially limits any major life activity, or for which you would require a reasonable accommodation in order to perform the job for which you have applied?
Are you currently able to commute to or plan to relocate to the Newtown/Langhorne Pennsylvania area(Required)
MM slash DD slash YYYY
Are you legally authorized to work in the United States(Required)
Will you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)?(Required)
Employment desired(Required)
Will you work overtime if required?(Required)
MM slash DD slash YYYY
Can you work evenings?(Required)
Can you work weekends, if required
Have you submitted an application here before?(Required)

NOTE: Answering “yes” to the following questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. (In answering these questions, do not include minor traffic infractions and convictions for which the record has been sealed or expunged, any conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed, referrals to and participation in any pre-trial or post-trial diversion programs, and marijuana-related offenses that occurred over two years ago.)

Have you ever pled “guilty” or “no contest” to, or been convicted of, a misdemeanor or felony?(Required)

Education History

Name of School Location (Complete mailing address) Years Completed Major & Degree Actions

Work Experience

Please list all fulltime and/or part-time work experience for the past five years beginning with your current or most recent employer. ALL INFORMATION MUST BE COMPLETED. If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer Employer Address (street address, city, state, zip) May we contact this employer? Name & title of supervisor Employment start date Employment end date Compensation start Your last job title: FT or PT Reason for leaving (be specific) List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. Actions

Computer Skills

Word Processing
Presentation (PowerPoint, etc.)

Personal References

List names and telephone numbers of three business/work references who are not related to you. If not applicable, list three school or personal references who are not related to you.

Name Relationship Actions

Referral Source (Please check the appropriate category and name the source)

Please read the following Applicant Statement carefully before signing:

I certify that all information I have provided in order to apply for and secure work with KVK Tech, Inc. is true, complete and correct.

I hereby give KVK Tech, Inc. the right to make a thorough investigation of my past employment, education and activities and I hereby authorize and request any present or former employer, educational institution, law enforcement agency, financial institution, or persons having personal knowledge about me to furnish KVK Tech, Inc., and/or its agents, with any and all information in their possession regarding me in connection with an application for employment. I release from all liability and hold harmless all persons, companies, organizations and entities supplying this information to KVK Tech, Inc. and/or its agents. I further indemnify KVK Tech, Inc. against any liability that might result from making such investigations. A photocopy of this authorization is as effective as the original. I certify under the pains and penalties of perjury that the facts stated herein are true and correct to the best of my knowledge, and that I have not omitted or concealed any relevant information. I understand that any false answers, slanders or implications made by me in this application or any other required documents, regardless of when they are discovered, shall be considered sufficient cause for denial of employment or discharge.

I understand that KVK Tech, Inc. does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I further understand that nothing contained in this Employment Application or in the granting of an interview is intended to create an employment contract between KVK Tech, Inc. and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon KVK Tech, Inc. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and KVK Tech, Inc. retains a similar right. I also recognize this application is conditional upon my presenting to KVK Tech, Inc. proper documents showing that I am eligible to work in the United States, I agree to submit to KVK Tech, Inc. the documents required by law showing work eligibility. I will provide KVK Tech, Inc. with copies of all employment and/or confidentiality agreements between me and any of my former employers that may contain continuing obligations on my part to any such employer.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient case to cancel further consideration of this application or immediately discharge me from KVK Tech, Inc.’ service, whenever it is discovered.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Max. file size: 32 MB.

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