* CK Construction conforms to the Immigration and Control Act of 1986 and requires associates to verify both their identity and their right to work in the United States.  Are you prevented from lawfully becoming employed in the country because of Visa or Immigration Status?:

Yes   No

* Are you at least 18 years or older?:

Yes   No

* Have you ever been employed by CK Construction?:

Yes   No

If yes, please provide details (when/job title/reason for leaving):

* Have you applied to CK Construction before?:

Yes   No

If yes, when:

* When would you be available to begin work?:

* Type of employment desired:

Full-Time Part Time

* Hourly rate/salary desired:

* Are you currently employed?:

Yes   No

If so may we inquire of your present employer?:

Yes   No

If presently employed, why are you considering leaving?:

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location	Did you Graduate?	Degree Received	Subjects Studied/Major
	Yes   No
	Yes   No
	Yes   No

Give your full employment record, starting with your current or most recent employment

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving

Name	Relationship	Phone Number	Email

By submitting this application, I certify that the answers given herein are true and complete. I authorize the investigation of all information contained in this application and hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others. I hereby release the Company from any liability as a result of such contact. False, misleading or omission of information discovered may result in the rejection of the application or is cause for dismissal at any time without any previous notice. Corna Kokosing is committed to providing a safe working environment for its associates. There is a proven relationship between alcohol and drug abuse and workplace accidents. Therefore, all Corna Kokosing applicants are required to submit to a pre-employment drug test once an offer of employment is extended. Corna Kokosing associates are required to submit to massive unannounced drug testing throughout their employment. I agree, if an offer of employment is extended or I become a Corna Kokosing associate, to give specimens of my body fluids for alcohol and drug testing by an approved testing laboratory. I understand that if I refuse to participate in a pre-or post-employment drug test that I will not be eligible for employment with Corna Kokosing.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and condition of my employment may be changed, with or without cause and with or without notice at any time by the company. I understand that no company representative, other than its' President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

* Signature (type name):

* Date:

Corna Kokosing Construction Company is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:

1. A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service connected disability.

2. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

3. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

4. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Protected veterans may have additional rights under USERRA-the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.

* If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I identify as one of the classifications of protected veterans listed above. I am not a protected veteran. I do not wish to answer.