Employment Application

You must complete entire application. We are an Equal Opportunity Employer.

* Required field




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  • Are there other names under which you have worked or attended school? If yes, please list for reference checking purposes. If no, please enter "none" in the required field below. *

  • Have you ever applied at this company before? *

    Yes
    No
    If yes, when?
  • Have you ever worked at this company before? *

    Yes
    No
    If yes, when?


  • Are you at least 18 years old? *

    Yes
    No

    If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work for which you are applying, and have obtained a work permit.


  • Are you legally authorized to work in the United States? *

    Yes
    No

    (If hired, you will be required to provide proof of work authorization.)


  • Have you ever been convicted of a crime (including all misdemeanors and felonies) or pleaded no contest for any offense or violation other than minor traffic violations? *

    Yes
    No

    If yes, explain 1) nature of crime, 2) date of conviction, and 3) state in which convicted.


    Convictions are not an automatic bar to employment.

  • Do you have any pending criminal charges against you? *

    Yes
    No

    If yes, explain the 1) nature of the charges, 2) date issued, and 3) county and state where issued.



  • Referral Source
    Please check the appropriate category and name the source.
    KMC Website
    Milwaukee Jobs
    WI Job Center
    Craig's List
    Career Builder
    Other (specify)
    Ozaukee Press
    Daily News
    Guide/Advantage
    Post
    News Graphic
    Employment Times
    Weekend Post
    Radio
    School (name)
    Employee Referral
    Other (specify)

  • Position Applying For
    1st Shift
    2nd Shift
    Any Shift

  • Education

























  • Training
    List any relevant training programs completed.

  • Skills and Qualifications
    Summarize any special training skills, licenses and/or certificates that may assist you in performing the position for which you are applying, including computer skills, software proficiency, etc. *

  • Employment History
    Starting with your most recent employer, provide the following information. List positions held for the past ten years.
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  • Explain any gaps in your employment, other than those due to personal illness, injury or disability.
  • Have you ever been fired or asked to resign from a job? *
    Yes
    No

    If yes, please explain:

  • References
    List individuals of business/work references who are not related to you and who are not personal friends:

  • Please read carefully before electronically signing this form.
    Applicant Statement

    I certify that all information I have provided in the application is true, complete and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment of be cause for subsequent dismissal if I am hired.

    I authorize the company to investigate my responses on this application and to contact any and all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining ay information, whether favorable or unfavorable, abut me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment.

    I understand that upon receiving a job offer, a physical examination and drug screening may be required.

    Regardless of whether or not I become employed by the company, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company's, unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer of the company, and the only by means of a signed, written document.

    I understand that this application remains current for 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

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


  • Thank you for your interest in our company.

  • Authorization and Release

    All information provided by me in support of my application for employment is true and correct to the best of my knowledge. I understand that misrepresentation of omissions may be cause for rejection or may be cause for subsequent dismissal if I am hired.

    I voluntarily and knowingly authorize any former employer, person, firm, corporation, organization, school, or government agency, its officers, employees and agents, to release all information concerning my former employment, and to release requested academic records and public record information, to said prospective employer, its officers, employees and agents, or any other person or entity making a written or oral request for such information on behalf of this employer. I understand the employment information may include, but in not necessarily limited to performance evaluations an reports, job descriptions, disciplinary reports, letters of reprimand, opinions, and public record information, regarding my suitability for employment possessed by it. I recognize a copy o f this authorization and release is as valid as the original and should be considered as such.

    I voluntarily and knowingly, fully release and discharge, absolve, indemnify and hold harmless such former employer, person, firm, corporation, school or government agency, its officers, employees and agents from any and all claims, liability, demands, causes of action, damages, or costs, including attorney's fees, present or future, whether known or unknown, anticipated or unanticipated, arising from or incident to the disclosure of release except for the malicious and willful disclosure of derogatory facts concerning my employment made for the express purpose of preventing me from obtaining employment which in the officer, employment or agent disclosing facts knows are untrue.


  • For reference checking purposes only, please complete the following information:
  • May your current supervisor, and/or any references or individuals associated with your current employer (including Human Resources) be contacted? *

    Yes
    No

    Specific Comments:

  • This information is required to conduct a criminal background Check.