| Location |
|
| Name |
|
| Email Address |
|
| Sex |
Male Female |
| Current Address |
|
| City |
|
| State |
|
| Zip |
|
| Years at Present Address |
|
| Home Phone |
|
| Work Phone |
|
| Are you a licensed driver? |
|
| If no, explain transportation. |
|
| Are you a U.S. Citizen? |
|
| Education |
| High School |
|
| Year Graduated |
|
| College |
|
| Year Graduated |
|
| Other |
|
| Year Graduated |
|
| Position Desired |
| You Would Like |
|
| Position |
|
| Start Date |
|
| Desired Salary |
|
| Are you presently employed? |
|
| Present Responsibilities |
|
| Present Employer |
|
| Do you have any friends or relatives employed with us? |
|
| How did you hear of this job? |
|
| Do you have any allergies or medical conditions? Explain. |
|
| Have you ever received compensation for injuries? Explain. |
|
Have you ever been convicted
of a felony? Explain. |
|
| The shifts you can work. |
|
|
| Former Employment |
Job 1
Dates Employed
Ending Salary
Work Performed
|
Employer Address and Phone
Reason for Leaving
|
Job 2
Dates Employed
Ending Salary
Work Performed
|
Employer Address and Phone
Reason for Leaving
|
Job 3
Dates Employed
Ending Salary
Work Performed
|
Employer Address and Phone
Reason for Leaving
|
| Emergency Contact |
| Name |
|
| Phone |
|
| References |
| Name, address and phone of three references who are NOT related to you and are NOT previous employers. |
| 1 |
| 2 |
| 3 |
| Applicant Statement |
| The information I have provided is true, correct and complete. False or incomplete information is sufficient cause for rejection of application or, if discovered after employment, cause for termination. I authorize KRG to contact and obtain information from past employers, educational institutions, credit agencies, references and any other person or party necessary to verify the accuracy of information disclosed on this application, related employment resume or personal interview. To assist in the processing of my application, I waive all rights and claims I may otherwise have against KRG or its representatives for seeking and using information to evaluate my request for employment, and all other persons, incorporations, agencies or organizations who provide information to this purpose. This application is not an employment agreement. If I accept an offer of employment, I understand and agree that my employment will be "AT WILL." I understand the employer may terminate my employment at any time, with or without cause, without prior notice, unless required by law. I understand that no one, other than an executive officer of KRG has the authority to enter into an employment agreement with terms contrary to the foregoing and then, only in writing signed by such officer.
By submitting this form, I understand and agree to accept all terms and conditions in the above statement.
|
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