Careers at Kuriyama of America, Inc.

Incomplete information could disqualify you from further consideration. Please complete all fields.

EMPLOYMENT DESIRED

Date you can start

Pay desired

Rate of pay

Are you currently employed? Yes No

If so may we inquire of your present employer? Yes No

REFERRAL SOURCE

How did you hear about us?

Walk-In Advertisement Referral Social Media Other

If Other, explain:

Have you ever worked for this company before?

Yes No

If yes, please explain:

Do you know anyone who works for our company?

Yes No

If yes, who?

EDUCATION

School Name

Location

Degree Received

Subjects or Major Studied

EMPLOYMENT HISTORY

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

From

Employer Name

Telephone

Address

Job Title

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities

Reason for leaving

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for?

If yes, explain:

REFERENCES

Give the names of three persons not related to you, whom you have known at least three (3) years.

Name

Years Acquainted

Phone

Company Name

Company Address

Name

Years Acquainted

Phone

Company Name

Company Address

Name

Years Acquainted

Phone

Company Name

Company Address

Please read carefully before agreeing below.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Kuriyama of America, Inc. to hire me. If I am hired, I understand that either Kuriyama of America, Inc. or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Kuriyama of America, Inc. has the authority to make any assurance to the contrary.

I attest by checking the box below that I have given to Kuriyama of America, Inc. true and complete information on this application. No requested information has been concealed. I authorize Kuriyama of America, Inc. to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Kuriyama of America, Inc.

Application for Employment

PERSONAL INFORMATION

Are you eligible to work in the U.S.?

Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)

Have you ever been terminated from employment or asked to resign by an employer?

Can you work any shift?

Can you work overtime, including weekends?

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?

EMPLOYMENT DESIRED

REFERRAL SOURCE

How did you hear about us?

Have you ever worked for this company before?

Do you know anyone who works for our company?

EDUCATION

EMPLOYMENT HISTORY

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for?

REFERENCES

Please read carefully before agreeing below.