Application for employment Personal information Date Last Name(required) Middle name First Name(required) Street Address(required) City(required) State(required) ZIP(required) Home Phone(required) Email Address(required) Business Phone Position desired(required) Have you ever applied for employment with us? Yes No If yes, when (month and year) Month January February March April May June July August September October November December Year How did you learn about the company? Pay expected Can you furnish proof of your right to work in the USA? Yes No Are you available to work weekends? Yes No Are you available to work holidays? Yes No Are you under 18 years of age? Yes No If yes, provide date of birth If under 16, can you submit a work permit? Yes No If hired, will you be able to report to work every day on time to perform your job duties? Yes No Hours available SUN From To MON From To TUE From To WED From To THU From To FRI From To SAT From To Total hours available per week Would you work Full Time Part Time Shifts preferred Day shift Night shift Are you willing to work overtime, when and as required? Yes No Educational Qualification 1 School Location of school Course of study No. of years completed Did you graduate Yes No Degree or Diploma Degree Diploma 2 Name of College Location of College Course of study No. of years completed Did you graduate Yes No Degree or Diploma Degree Diploma 3 Other School Location of school Course of study No. of years completed Did you graduate Yes No Degree or Diploma Degree Diploma Are you going to school now? Yes No If yes, where Day classes or Night classes Day classes Night classes Employment History 1 Company Name Mailing Address 1 Mailing Address 2 Phone no. Name of Supervisor Job Title Employed from To Weekly pay start end Describe your work Reason for leaving May we contact this employer? Yes No If not, why not? 2 Company Name Mailing Address 1 Mailing address 2 Phone no. Name of Supervisor Job Title Employed from To Weekly pay start end Describe your work Reason for leaving May we contact this employer? Yes No If not, why not? 3 Company Name Mailing Address 1 Phone no. Name of Supervisor Job Title Employed from To Weekly pay start end Describe your work Reason for leaving May we contact this employer? Yes No If not, why not? What atributes are you bringing you to this job? Any other information you would like to share Signature I certify that the information given herein is true and complete to the best of my knowledge. I authorize you to make such investigations and inquires of the information provided herein, and other matters related thereto, as may be necessary. I hereby release employers, schools, and other persons, institutions or businesses from all liability in responding to inquiries in connection with my application. I understand that false or misleading information given in my application or during interviews may result in a refusal to hire, or discharge in the event of employment. I understand and agree that, if hired, my employment is at will. I also understand that if I am hired my employment is for no definite period of time. I may terminate my employment at any time and I may be dismissed at any time without prior notice. I further understand and agree that nothing in this application shall constitute a contract of employment or shall constitute a contract or a guarantee of employment. I also understand that any policies or procedures implemented by the company in the event of my employment are for purposes of operation only and are not intended to be nor constitute a contract for my employment. In addition, I understand that any of these policies or procedures may be changed at any time at the employer's discretion and without notice. Any offer of employment with Kath Fuel Oil Co. may be contingent on your ability to pass a criminal background check. A criminal conviction will not necessarily disqualify you from the job for which you are applying. Rather, a conviction will be considered with respect to your anticipated job duties, passage of time since the conviction, severity of offense and other relevant factors. Signature(required) Date(required) Please confirm that you are human by entering the code at right into the box cforms contact form by delicious:days