Full Name:
Address: City:
State:
Zip:
Phone:
*E-mail:
Driver License #:
Driver License State:
Employment Desired
Position applying for:
Full-time?
If applying for temporary work, when will you be available?
Start Date:
Would you be available to work overtime if necessary?
Yes:
If hired, on what date can you start work?
Salary desired:
Personal Information Have you ever applied to or worked for FSP or KLS before?
Do you have any friends or relatives working for FSP or KLS?
Name:
Why are you applying for work at FSP or KLS?
Are you at least 18 years old?
(If under 18, hire is subject to verification that you are of minimum legal age.)
If hired, can you present evidence of your U.S. citizenship or proof of your legal
right to live and work in this country?
(note: Employment may be conditioned on the satisfactory result
of a post-offer medical examination or medical inquiry if this is
required of all entering employees in the same job category.)
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
Convictions for marijuana-related offenses that are more than two years old need not be listed.)
If yes, state nature of the crime(s), when and where convicted
and disposition of the case:
(note: No applicant will be denied employment solely on the grounds of conviction
of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance
of the offense to the position(s) applied for may, however, be considered.)
Are you currently employed?
Yes:
If so, may we contact your current employer?
Yes:
Education & Training High School: College/University: Business/Vocational: Other (describe):
Language:
Speak:
Write:
Understand:
Language:
Speak:
Write:
Understand:
Do you have any Licensing/Certification relevant to the job applied for?
Name of License/Cert.:
Has your license/certification ever been revoked or suspended?
If yes, state reason(s), date of revocation or suspension and date of reinstatement:
Employment History List below all present and past employment starting with your most recent
employment starting with your most recent employer (last five years is sufficient). Account for all periods of
unemployment. You must complete this section even if attaching a resume.
Employer Name:
Your Position & Duties:
Address:
Phone Number:
Supervisor's Name:
Dates Start:
Starting Salary:
Reason for Leaving:
May we contact this employer for a reference?
Yes:
Employer Name:
Your Position & Duties:
Address:
Phone Number:
Supervisor's Name:
Dates Start
Starting Salary:
Reason for Leaving:
May we contact this employer for a reference?
Yes:
Employer Name:
Your Position & Duties:
Address:
Phone Number:
Supervisor's Name:
Dates Start:
Starting Salary:
Reason for Leaving:
May we contact this employer for a reference?
Yes:
Computer Skills
Indicate your skill level:
Microsoft Word:
Excel:
List other Computer skills / training / experience:
Military Service Have you obtained any special skills or abilities as the result of service in the military?
If so, describe:
References List below three persons not related to you who have knowledge of your work
performance within the last three years.
Name:
Telephone:
Address:
City,State Zip:
Occupation:
Number of Years Acquainted:
List below three persons not related to you who have knowledge of your work
performance within the last three years.
Name:
Telephone:
Address:
City,State Zip:
Occupation:
Number of Years Acquainted:
List below three persons not related to you who have knowledge of your work
performance within the last three years.
Name:
Telephone:
Address:
City,State Zip:
Occupation:
Number of Years Acquainted:
Please Read Carefully and Check Each Box If You Agree
I hereby certify that I have not knowingly withheld any information that might
adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge.
I further certify that I, the above named applicant, have personally completed this application. I understand that any
omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds
for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I hereby authorize the company to thoroughly investigate my references, work record,
education and other matters related to my suitability for employment and, further, authorize the references I have listed
to disclose to the company any and all letters, reports and other information related to my work records, without giving
me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons,
corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way
related to such investigation or disclosure.
I understand that nothing contained in the application, or conveyed during
any interview which may be granted or during my employment, if hired, is intended to create an employment contract between
me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable
period and may be terminated at any time, with or without prior notice, at the option of either myself or the company,
and that no promises or representation contrary to the foregoing are binding on the company unless made in writing and signed
by me and the company's designated representative. Employment subject to approval of background check results.
Full Name: Email:
RESET SUBMIT
