EmailMe Form - KGS Employment Application

APPLICANT INFORMATION

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Date Time

MM / DD / YYYY

Phone

### - ### - ####

Email

Date Available

MM / DD / YYYY

Social Security No.

Driver’s License

State issued

CDL

Yes

No

Referred to KGS by

Desired Salary

Position Applied for

Are you willing to Travel out of state ?

Yes

No

Are you a citizen of the United States?

Yes

No

If no, are you authorized to work in the U.S.?

Yes

No

Have you ever worked for this company?

Yes

No

Have you ever worked for this company?

Yes

No

Have you ever been convicted of a felony?

Yes

No

If yes, explain

EDUCATION

High School

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

From

MM / DD / YYYY

To

MM / DD / YYYY

Did you graduate?

Yes

No

Degree

College

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

From

MM / DD / YYYY

To

MM / DD / YYYY

Did you graduate?

Yes

No

Degree

Other

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

From

MM / DD / YYYY

To

MM / DD / YYYY

Did you graduate?

Yes

No

Degree

PROFESSIONAL LICENSE OR MEMBERSHIP

(You need not disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.)

Type of License(s) Held

License Number(s)

License Expiration Date(s)

Other Professional Memberships

PREVIOUS EMPLOYMENT

Company

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Company

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Company

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

MILITARY SERVICE

Branch

From

MM / DD / YYYY

To

MM / DD / YYYY

Rank at Discharge

Type of Discharge

If other than honorable, explain

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Should I be considered for employment, I agree and consent to verification of references and previous employment as well as MVR/background and drug screening.

Signature

Date Time

MM / DD / YYYY

WORK RELATED REFERENCES

Please list three professional references.

Full Name

Relationship

Company

Phone

### - ### - ####

Address

Full Name

Relationship

Company

Phone

### - ### - ####

Address

Full Name

Relationship

Company

Phone

### - ### - ####

Address

I HAVE PREVIOUS EXPERIENCE WITH:

Please list any additional experience

Rough Terrain Fork Lift

Yes

No

Where

Roustabout

Yes

No

Where

Tank Cleaning

Yes

No

Where

Water Filtration

Yes

No

Where

Water Transfer

Yes

No

Where

Heavy Equipment

Yes

No

Where

Commercial Driver
Fitness Determination

Yes

No

Where

Attach Documents

Please upload your cover letter and resume.

Cover Letter *

Resume *