Kerby Enterprises Job Application

Please complete the application for employment below.
Please note: Anyone who is considered for employment will have to complete a Background Check Release Form.

Due to the increasing amount of applicants, please do not call to check on the status of your application.
The Human Resources Director will contact you if an interview is needed. Thank you.
PERSONAL INFORMATION
LAST NAME
FIRST NAME
EMAIL
 
PRESENT ADDRESS
CITY
STATE
ZIP
PERMANENT ADDRESS
CITY
STATE
ZIP
PHONE NO.
REFERRED BY
EMPLOYMENT DESIRED
POSITION
DATE YOU CAN START
RadDatePicker
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SALARY DESIRED
ARE YOU EMPLOYED NOW?
IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER?
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE US?
EVER APPLIED TO THIS COMPANY BEFORE?
WHERE?
WHEN?
RadDatePicker
Open the calendar popup.
EDUCATION HISTORY
  NAME & LOCATION OF SCHOOL YEARS ATTENDED DID YOU GRADUATE? SUBJECTS STUDIED
HIGH SCHOOL
COLLEGE
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL
GENERAL INFORMATION
SUBJECTS OF SPECIAL STUDY/RESEARCH WORK
SPECIAL TRAINING
SPECIAL SKILLS
U.S. MILITARY OR NAVAL SERVICE
RANK
FORMER EMPLOYERS (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)
DATE
MONTH AND YEAR
NAME & ADDRESS OF EMPLOYER SALARY POSITION REASON FOR LEAVING
FROM
RadDatePicker
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TO
RadDatePicker
Open the calendar popup.
FROM
RadDatePicker
Open the calendar popup.
TO
RadDatePicker
Open the calendar popup.
FROM
RadDatePicker
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TO
RadDatePicker
Open the calendar popup.
FROM
RadDatePicker
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TO
RadDatePicker
Open the calendar popup.
REFERENCES GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
NAME ADDRESS BUSINESS YEARS KNOWN

AUTHORIZATION

"I certify that the facts contained in t his application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."