ONLINE EMPLOYMENT APPLICATION

Position Applied For:  
First Name:  
Middle Name:
Last Name:  
Street Address:
City:
State:
Zip Code:
Home Phone:
Office Phone:
Referral Source:




Have you filed an application here before?
Have you ever been employed here before?
Are you available for work?
Are you on lay-off and subject to recall?
Can you travel if required?
Do any of your friends or relatives, other than your spouse, work here?
If yes, list name(s):  
Have you been convicted of a felony within the last 7 years?
If yes, explain:

MILITARY SERVICE RECORD

Were you in the U.S. Armed Forces?
If yes, what branch:  
List duties in the service including special training:
Have you taken any training under the G.I. Bill of Rights?
If yes, what training did you take:  

PREVIOUS EMPLOYMENT

Company Name,
Address and,
Type of Business:
From Month/Year:
To Month/Year:
Describe
the work
you did:
Weekly Start
Salary:
Weekly End
Salary:
Reason for
Leaving:
May we contact
this employer?
Contact Phone#:
Supervisor
Name and
Title:

*You MUST click 'Add Record' for your previous employment information to be added.




Have you ever been bonded?
If yes, on what jobs?
When will you be available to begin work?  

EDUCATION

High School College/University Graduate/Professional
Name of School
Years Completed
Diploma/Degree
Describe Course
of Study


Describe specialize
training,
apprentice-ship,
skills, and extra-
curricular
activities
Honors Received:
Membership in
Professional Organizations
and Societies
Professional
Registrations


State any additional information you feel may be helpful to us in considering your application:
Attach a Resume:  


APPLICANTS STATEMENT
    I certify that the information contained in this application is true and complete to the best of my knowledge. I  understand  that  any false  statements,   misrepresentations,  or OMISSIONS on this application,  or any  accompanying resume or other similar documents, are grounds for not hiring me or, if I am employed, my immediate dismissal. I authorize the references listed to provide the company with any and all information and personal files concerning my previous employment and to disclose any pertinent information that they may have, personal or otherwise. I hereby release all parties from any and all liability or damages that may result from furnishing this information or documentation to the company. I understand that if offered employment, I may be required to undergo a medical examination, including tests for the detection of illegal drugs or alcohol, before becoming employed. I further agree to authorize the release of any and all medical records, past or present, to the company.
    I further understand that this application is not a contract of employment of definite duration and that the terms of my employment, if hired, will be terminable at will. I further understand that no manager or supervisor other than the President of Kenvirons, Inc. has any authority to enter into an employment agreement for any specified period of time, or to make any agreement contrary to the foregoing. Any such agreement by the President must be in writing.



 
 
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