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Employment Application Form
Last Name:
*
First Name:
*
Middle Name(s):
About You
Just a heads up - you need to be 16 years or older to apply
Gender
*
Male
Female
Marital Status
Single
Married
National Registration No. (ID#):
*
National Insurance No. (NIS#):
Tax Identification No. (TIN#):
Contact Information:
Home Address
*
Telephone No:
Cell Phone:
*
Email Address:
*
Please use your personal email address and not a school or shared email address.
In case of Accident/Emergency #1 :
Name:
Relation:
In case of accident/emergency:
Tel #:
In case of accident/emergency:
In case of Accident/Emergency #2 :
Name:
Relation:
In case of accident/emergency:
Tel #:
In case of accident/emergency:
Do you have any friends or family working at KFC? If yes, please state the name of the person you know who works at KFC?
*
Yes
No
Name
Health Details:
Have you ever had a major operation/injury/accident?
Yes
No
Total days missed due to the above.
Explain any compensation received.
State any major illnesses or allergies:
Drivers ONLY:
Do you hold a current drivers licence?
Yes
No
If yes state:
Light Goods
Heavy Duty
Motorcycle
If yes state how long:
Under 1 year
1 – 3 years
Over 3 years
Do you own your own vehicle?
Yes
No
POSITION APPLIED FOR
State position(s) applied for:
Expected Rate of Pay:
$ per hour/week
Employment Desired:
Full-Time
Part-Time
If Part-Time, specify days and hours:
Are you willing to work in any location?
Yes
No
If no, please state why:
Can you work on Saturdays/Sundays/Holidays?
Yes
No
If no, please state why:
Can you work a shift system?
Yes
No
If no, please explain:
If your application is successful, what date will you be available to commence your duties? (mm/dd/yyyy)
*
EDUCATION
Secondary School:
Last Form Completed:
Did you do any CXCs?
Yes
No
If yes, please state subjects and grades received (e.g. Maths(1)):
*
Other Qualifications/Training/Apprenticeships
College/University/Institution Subject/Course/ Skills
Subject/Course/ Skills Training
Date Gained
Grade (indicate pass, fail or your current status if no grade is applicable)
Add
Remove
EMPLOYMENT RECORD
Please list past employment beginning with the most recent.
Name of Company
Job Title
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Supervisor
Reason For leaving
Add
Remove
CRIMINAL BACKGROUND
Have you ever been arrested and/or convicted of a crime?
*
Yes
No
If yes, please explain:
REFERENCES
Please give name, occupation, address/company of two (2) references. One must be your present or most recent employer. If you have never worked before, please name a teacher/instructor. References from friends and relatives are not acceptable.
Name
Occupation
Address/Company
Telephone
Name
Occupation
Address/Company
Telephone
RELEASE OF INFORMATION AND SIGNATURE
I authorise my previous employers to provide any information requested concerning my past employment and hereby release them of any liability in connection with such disclosure.
I also certify that the information stated in this application is true and I understand if found false will be viewed as a breach of my employee contract which may lead to dismissal.
This application was completed by:
*
Self
Relative/Friend/Other
If relative/friend /other, please state who below:
Applicant’s Signature
Relative/Friend/Other
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