KLI Online Employment Application

This employment application form is intended for use in evaluating your qualifications for employment. This is not an employment contract.

Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered, after employment, terminating employment.

All qualified applicants will receive consideration without discrimination because of sex, marital status, race, color, age, creed, national origin, sexual orientations, military reserve membership, ancestry, religion, height, weight, use of a guide or support animal because of blindness, deafness or physical handicap, or the presence of disabilities.

A felony conviction will not necessarily bar an applicant from employment. Additional testing of job-related skills and for the presence of drugs in your body may be required for employment. After an offer of employment, and prior to reporting for work, you may be required to submit to a medical review. Depending on company policy and the needs of the job, you will be required to complete a medical history form and may be required to be examined by a medical professional designated by the company.

KLI Online Employment Application
First Name (*)

Invalid Input
Middle Name

Invalid Input
Last Name (*)

Invalid Input
Home Phone (*)

Invalid Input
Cell Phone

Invalid Input
Email

Please provide a valid email address.
Current Address (*)

Invalid Input
City (*)

Invalid Input
State (*)

Invalid Input
Zip Code (*)

Invalid Input
Previous Address

Invalid Input
City

Invalid Input
State

Invalid Input
Zip Code

Invalid Input
What position are you applying for? (*)

Please select a position that you are applying for.
Give a brief description of your experience relating to the position you are applying for. (*)

Please specify your experience.
Do you understand the essential functions of this job? (*)

Please specify if you understand the functions of this job.
Can you perform the essential functions of this job with or without reasonable accomodations?

Invalid Input
What date can you start? (*)

Please give a start date.
What type of work do you prefer?: (*)

Invalid Input
For which schedule are you available to work? (*)

Please provide which schedule you are available to work.
Please list all languages you are fluent in:

Invalid Input
Please list any other skills, licenses, or certificates that may be job-related or that you feel would be of value to this company:

Invalid Input
If the job requires, do you have the appropriate valid drivers license?

Invalid Input
Have you had any moving violations?

Invalid Input
If yes, please describe the violation(s).

Invalid Input
Please List the City, State and County of residence for the past 7 years.

Invalid Input
Have you been convicted of a crime in the past seven years? (*)

Please answer if you have been convicted of a crime in the last 7 years.
If yes, please describe - Date of incident, City/State, Charge. (Conviction will not necessarily be a bar to employment. In accordance with company policy and applicable state and federal laws, factors such as age at time of offense, remoteness of the offense, time since last conviction, nature of the job sought and rehabilitation effort will be reviewed.)

Invalid Input
Comments about incident:

Invalid Input
Most recent employer Company Name

Invalid Input
City

Invalid Input
State

Invalid Input
Dates of Employment

Invalid Input
Job Title

Invalid Input
Supervisor

Invalid Input
Ending Pay

Invalid Input
Duties

Invalid Input
Reason for leaving

Invalid Input
Second most recent employer Company Name

Invalid Input
City

Invalid Input
State

Invalid Input
Dates of Employment

Invalid Input
Job Title

Invalid Input
Supervisor

Invalid Input
Ending Pay

Invalid Input
Duties

Invalid Input
Reason for leaving

Invalid Input
Third most recent employer Company Name

Invalid Input
City

Invalid Input
State

Invalid Input
Dates of Employment

Invalid Input
Job Title

Invalid Input
Supervisor

Invalid Input
Ending Pay

Invalid Input
Duties

Invalid Input
Reason for leaving

Invalid Input
Please list 3 References that are familiar with your work ability. DO NOT list relatives.: Name, Phone, Relationship, Years Known

Invalid Input
If your school records are under a different name than the name provided, please give name school records are under:

Invalid Input
What is the highest grade level you have completed? (Note: Do not fill out any part of this section you believe to be non job related.)

Invalid Input
Please List Names of Schools attended, City & State, Dates of attendance, Graduation Date (if applicable) (Note: Do not fill out any part of this section you believe to be non job related.)

Invalid Input
I certify that I have read and understand the applicant note at the beginning of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this electronic form or not, may result in rejections of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information. I authorize all former employers, persons, schools and companies to release job related information.I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. By typing in your name and date below you are agreeing to the above applicant note and the certification and release statement above. (*)

Please read the Certification and Release.
Type Full Name (*)

Please type your name to acknowledge that you have read the Certification and Release.
Date (*)

Please put today's date.
Please type in code for verification
Please type in code for verification

Invalid Input