Jrkflaggers
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Highway Flagger
All areas
,
PA
,
USA
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Application Form
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First Name *
Last Name
Email *
Phone *
How did you hear about this position?
--Select--
Indeed
JRK Employee
Other
Address *
Current Salary
What county in Pennsylvania do you reside? *
--Select--
Adams
Allegheny
Armstrong
Beaver
Bedford
Berks
Blair
Bradford
Bucks
Butler
Cambria
Cameron
Carbon
Centre
Chester
Clarion
Clearfield
Clinton
Columbia
Crawford
Cumberland
Dauphin
Delaware
Elk
Erie
Fayette
Forest
Franklin
Fulton
Greene
Huntingdon
Indiana
Jefferson
Juniata
Lackawanna
Lancaster
Lawrence
Lebanon
Lehigh
Luzerne
Lycoming
McKean
Mercer
Mifflin
Monroe
Montgomery
Montour
Northampton
Northumberland
Perry
Philadelphia
Pike
Potter
Schuylkill
Snyder
Somerset
Sullivan
Susquehanna
Tioga
Union
Venango
Warren
Washington
Wayne
Westmoreland
Wyoming
York
Outside Pennsylvania
Date of application? *
Position applied for? *
Drivers license state? *
Are you over the age of 18? *
--Select--
Yes
No
Were you previously employed by JRK Enterprises? *
--Select--
Yes
No
If yes, give dates.
Date available for work? *
Desired salary?
Type of employment desired? *
Full time
Part time
Temporary
Seasonal
Educational Co-Op
Are you able to meet the attendance requirements of the postion? *
--Select--
Yes
No
Have you ever been convicted of a crime, except a minor traffic violation? *
--Select--
Yes
No
If yes, provide dates and details
Have you ever been discharged from a position or requested to resign from a position? *
--Select--
Yes
No
If yes, please give circumstances.
Employment History-Starting with your most recent employer first. Provide company name, address and phone number. *
From and to, provide dates. *
Job title and summary of work performed? *
Immediate Supervisor? *
Hourly rate or Salary?
May we contact for reference? *
--Select--
Yes
No
Later
Are you still currently employed by this company? *
--Select--
Yes
No
Reason for leaving or wanting to leave? *
Employer #2- provide company name, address and phone number?
Dates employed: to and from.
Job title?
May we contact for a reference?
--Select--
Yes
No
Later
Reason for leaving?
Employer #3- provide company name, address and phone number?
Date employed: to and from.
Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying
Have you ever served in the U. S. Armed Forces? *
--Select--
Yes
No
If Yes, branch?
Date Entered?
Date discharged?
High School? *
Number of years completed? *
Did you graduate? *
--Select--
Yes
No
GED
College?
Did you finish and graduate?
Other education?
List all references. Include; name, relationship, phone and number of years known.
Did you or will you be filling out our Affirmative Action Voluntary Information Form? (You can do so by going back to our website
www.jrkflaggers.com
and going back into our job application link. You can then follow the information on #2 to email this information in. Remember, this information is voluntary.) *
--Select--
Yes
No
Are you subject to recall from a current lay off? *
--Select--
Yes
No
Thanks for your time
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