Employment - Krist Oil Co.

General Information

Position Desired

Position Location

Date Available

Will you work nights?

Referred by

Name (Last, First, Middle)

Present Address (No., Street, City, State and ZIP)

How long have you lived at your present address

Previous Address (No., Street, City, State and ZIP)

How long did you live at your previous address

Telephone No.

Are you at least 18 years of age?

Do you have a valid Drivers License?

Have you ever worked for or applied for work at Krist Oil Company?

If so, where and when?

Education

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Employment History

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Explain any lapsed time in your above employment

How many days of work have you missed in the past 12 months?

Personal References

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Authorization to Release Information

Date of Birth

Driver's License Number

State

Have you ever been convicted of a felony?

If so, explain

Note: A pending arrest or conviction record is not an automatic bar to employment, and will only be considered if the circumstances of the offense are substantially related to the circumstances of the particular job applied for, or if bondability is required.

We appreciate your consideration as a perspective employer. While processing your application for employment, we may make a routine inquiry into your background concerning your general reputation and character. Further information on the nature and scope of such an inquiry, if one is made, is available to you upon written request.

"I certify that the information supplied in this application is true and complete to the best of my knowledge. I understand that if any fo the information I have given in the application or subsequent interviews is false, I am subject to immediate dismissal if I have been employed. If I am considered for employment, I authorize the company to communicate with the employers references, and agencies that provide criminal background check information, listed in connection with this application, and authorize them to give the company any and all information concerning my previous employment and any other pertinent information they may have; moreover, I release all parties for all liability for any damage that may result from furnishing such information to the company."

"I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time without prior notice and without cause."

Signature (Use mouse or finger)

Date of Signature