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Employment Application
Name: Kramer Last Telephone: 641-220-3819 Address:
710 7th St N LOT 5 Gabriel

COMPANY OR EMPLOYER NAME:

Position applying for:
Mechanical Engineer

EMPLOYEE INFORMATION
Paul

First Email: 14gkramer@nkstudents.com

Middle Alternate telephone:

Are you able to perform the essential functions of the position with or without accommodations?
Yes 14 18 Yes No 15 19 No Yes No 16 21 (Check one)

If necessary for the job are you older than:

If necessary for the job, I am able to: Yes Work overtime? Yes Provide a valid Alaska Driver's License? If so, fill out the following: Issuing state: Type: Endorsement(s):
Hazardous Material Tankers School Bus Any Split Day Night Other:

No No

Passengers

I am legally eligible for employment in the U.S.? I am seeking a permanent position:

Tank with Hazardous Materials Double/Triple trailers Swing Rotating

Work the following shifts: (check all that apply)

Graveyard

I will be able to report to work 14 days after being notified I am hired.

EMPLOYMENT HISTORY
List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.

Employer name and address:

Holiday Inn Express Hotel & Suites 4712 Wheelerwood Rd. Northwood IA 50459

Position title/duties, skills:

Assistant Maintenance Helped out maintenance and did odd jobs around the Hotel. Helped change beds and paint.
Telephone: 641-323-7500

Start date:

3/11

End date:

8/11

Reason for leaving:

Pay: $ 7.25 Per: hour Employer name and address: Northwood-Kensett High School 1200 1st Ave. N Northwood, IA Pay: $ 7.25 Per: hour Employer name and address:

School started again.

Supervisor: Ann Dick Position title/duties, skills:

Janitor Cleaned the inside of the school including tables, chairs, and desks.
Telephone: 641-390-0237

Reason for leaving: School started again.

5/12, 5/13 8/12, 8/13

Start date:

End date:

Supervisor: Kent Nitcher Position title/duties, skills:

Start date:

End date:

Reason for leaving: Pay: $ Per: Employer name and address:

Supervisor: Position title/duties, skills:

Telephone: Start date: End date:

Reason for leaving: Pay: Per: $ Supervisor: Telephone:

Employment Application Page 1 of 2

Rev. 8/2010

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Summarize other employment related to this job:

EDUCATION
Institution name High school Northwood-Kensett High School College/university Business/technical Additional Years completed
three

Field of study

Graduate or degree

MILITARY
Are you a veteran? Duty/specialized training: Yes No

SKILLS & QUALIFICATIONS

Other qualifications such as special skills, abilities or honors that should be considered: Types of computers, software, and other equipment you are qualified to operate or repair:
I can operate tractors and can x any sort of car or tractor.

Professional licenses, certifications or registrations: Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employers attention:
I had three years of Spanish.

Typing speed:

40

per minute

REFERENCES
List two personal references who are not relatives or former supervisors.
Dennis Nagle Name Mr. Hartman Name 872 450th St Address 567 3 ave. N Address 641-390-1352 Telephone 641-390-4567 Telephone Farme r Occupation Teacher Occupation 8 years Years known 6 years Years known

CONTACT
In case of accident or illness, please contact: Name: Noelle Kramer Address: 710 7th St N LOT 5 Daytime phone: 641-324-8562 Relationship: Mother

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its terms. I understand and agree to the information shown above. 2/7/14 Gabe Kramer

Signature of Applicant

Date

Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment. Developed at employer request by the Alaska Department of Labor & Workforce Development, Employment Security Division. Rev. 8/2010 Employment Application Page 2 of 2