Application For Employment

Kearns Brothers, Inc., is an Equal Opportunity Employer and is committed to excellence through diversity.

   Personal Information
Name
Current Address
City
State
Zip
Previous Address
City
State
Zip
Phone Number
Mobile Number
Email Address
Are You A U.S. Citizen and Authorized to work in the US?
Have you ever been convicted of a crime or arrested for a felony?
Are You 18 Years of Age or Older?
   Position
Position You Are Applying For
Available Start Date
Desired Pay
Employment Desired
   Education
School Name Location Years Attended Degree Recieved Major
School Name
Location
Years Attended
Degree Recieved
Major
School Name
Location
Years Attended
Degree Recieved
Major
School Name
Location
Years Attended
Degree Recieved
Major
   Refrences
Name & Title Company Email Address Phone
Name & Title
Company
Email Address
Phone
Name & Title
Company
Email Address
Phone
Name & Title
Company
Email Address
Phone
   Employment History
Employer(1)
Job Title
Dates Employed
Work Phone
Starting Pay Rate
Ending Pay Rate
Address
City
State
Zip
Employer(2)
Job Title
Dates Employed
Work Phone
Starting Pay Rate
Ending Pay Rate
Address
City
State
Zip
Employer(3)
Job Title
Dates Employed
Work Phone
Starting Pay Rate
Ending Pay Rate
Address
City
State
Zip
   Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.
 
I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, consumer reporting agencies, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.
 
I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.
 
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
 
I agree that any action or suit against the Company, its agents or employees, arising out of my employment or termination of employment, including, but not limited to, claims arising under State but not Federal, civil rights statutes, must be brought within 180 days of the event giving rise to the claims or be forever barred unless the applicable statute of limitations period is shorter than 180 days in which case I will continue to be bound by that shorter limitations period. I waive any limitation periods to the contrary. I further agree that if I should bring any non-statutory action or claim arising out of my employment against the Company, in which the Company prevails, I will pay to the Company, any and all such costs incurred by the Company in defense of said claims or actions, including attorney fees.
 
I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employers service whenever it is discovered.
 
Do not sign until you have read the above Applicant Statement.
 
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement. Furthermore, this certifies that this application was completed by me and that all entries on it and information in it are true and complete to the best of my knowledge.

SIGNATURE X____________________________________________________ DATE X_____________________