(Please Print)
      
    
NAME:
Last First Middle Maiden
Present Address
Number, Street, City, State, Zip
How long Have You Been At Present Address:
Social Security No.
Telephone

                             Home:


                               Cell:

                           
                              Email:

Best Time Of Day To Contact You:
If under 18, please list age:
Can you legally work in the United States?
YES
NO
Position applying for?
Salary Desired?
Days/hours available to work?
THURS
No Pref
FRI
MON
SAT
TUES
SUN
WENS
How many hours can you work weekly?
Employment desired:
FULL-TIME ONLY
FULL- OR PART-TIME
PART-TIME ONLY
                                     

TYPE OF SCHOOL       NAME OF SCHOOL           LOCATION        NUMBER OF YEARS COM.     MAJOR &
DEGREE                                                                                                                  
HIGH  SCHOOL OR
GED
COLLEGE
BUS. OR TRADE SCHOOL
PROFESSIONAL SCHOOL
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
YES
NO


If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how
recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Please list two references other than relatives or previous employers.
Name

Position

Company

Address
Name

Position

Company

Address
Name of previous Employer

Address

Phone Number

Name of last supervisor

Employment dates

Hourly or salary

Starting pay

Final pay

Your last job title

Reason for leaving
(be specific)
Hourly
Salary

List the jobs you held, duties performed, skills used or learned,
advancements or promotions while you worked at this company.
In a few short sentences tell us why we should hire you and
what makes you so unique as an individual.
PLEASE READ CAREFULLY AND
CHECK BOXES AT BOTTOM
Authorization to
Release Information


I have applied for a position with Kennett Oil,
Kennett River City Marathon, Kennett Truck Stop,
Aurora Farm and Garden  (companies).

I have been requested to provide information for
their use in reviewing my background and
qualifications. Therefore, I hereby authorize the
investigation of my past and present work,
character, education, military and employment
qualifications.

The release in any manner of all information by you
is hereby authorized whether such information is of
record or not, and I do hereby release all persons,
agencies, firms, companies, etc., from any
damages resulting from providing such
information.
Consent for Drug/Alcohol Screen Testing

If you are offered and accept employment with
Kennett Oil, Kennett River City Marathon,
Kennett Truck Stop, Aurora Farm and Garden  
(companies), in the interest of safety for all
concerned, you might be selected at any time
before or during employment to take a test for
drug and/or alcohol use.

By clicking YES in the check box, you have been
fully informed of the reason for this urine test for
drug and/or alcohol (I understand what I am
being tested for), the procedure involved, and
do hereby freely give my consent.

If this test is positive, and for this reason I am
not hired, I understand that I will be given the
opportunity to explain the results of this test.

I hereby authorize these test results to be
released to Kennett Oil, Kennett River City
Marathon, Kennett Truck Stop, Aurora Farm and
Garden.
Yes I am consenting to
 this Authorization to
Release form
Yes I am consenting to a
drug and or alcohol test
No I am not consenting
to this Authorization to
release form
No I am not consenting to
a drug and or alcohol test
Application For Employment