Emp Application KK
Emp Application KK
Emp Application KK
Employment Application
An Equal Opportunity Employer-
Kountry Kitchen is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for
employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodations in the application and/or
interview process should notify a representative of Kountry Kitchen.
PLEASE print CLEARLY and fill out ALL SECTIONS or APPLICATION will NOT be CONSIDERED.
Are you applying for: Full Time [ ] or Part Time [ ] [ ] SUN _______________
Employment History
Are you currently employed? [ ] YES | [ ] NO If yes, may we contact your employer? [ ] YES | [ ] NO
Be l o w , p l e a se d e sc r i b e t h e p a st a n d p r e se n t e mp l o y me n t p o si t i o n s, d a t i n g b a c k f i ve ye a r s. Pl e a se a c c o u n t f o r a l l
p e r i o d s o f u n e mp l o yme n t . E ve n i f yo u a t t a c h e d a re su me , t h i s se c t i o n mu st b e c o mp l e t e d .
Name of Employer: _________________________________ Business Type: _________________________
Telephone Number: ________________________________ Name of Supervisor: ___________________________
Address: _________________________________________________________________________________________
Date of Employment: ______________________________________________________________________________
Position & Duties: _________________________________________________________________________________
Reason for Leaving: ________________________________________________________________________________
May we contact this employer for references? [ ] YES | [ ] NO
Name of Employer: _________________________________ Business Type: _________________________
Telephone Number: ________________________________ Name of Supervisor: ___________________________
Address: _________________________________________________________________________________________
Date of Employment: ______________________________________________________________________________
Position & Duties: _________________________________________________________________________________
Reason for Leaving: ________________________________________________________________________________
May we contact this employer for references? [ ] YES | [ ] NO
Name of Employer: _________________________________ Business Type: _________________________
Telephone Number: ________________________________ Name of Supervisor: ___________________________
Address: _________________________________________________________________________________________
Date of Employment: ______________________________________________________________________________
Position & Duties: _________________________________________________________________________________
Reason for Leaving: ________________________________________________________________________________
May we contact this employer for references? [ ] YES | [ ] NO
2
References
List below three persons who have knowledge of your work performance within the last four(4) years. Please include
professional reference only.
Name – First, Last: ____________________________________________________________
Telephone Number: ____________________________________________________________
Address: ____________________________________________________________
City, State, Zip: ____________________________________________________________
Occupation: ____________________________________________________________
Number of Years Acquainted: ______________________________________________________