KETCH APPLICATION FOR EMPLOYMENT

KETCH APPLICATION FOR EMPLOYMENT 1006 E Waterman, Wichita, KS 67211

We are an equal opportunity employer
Application Date:
Full Name

First NameLast Name
Other name(s) under which you have worked or attended school:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Best phone number to reach you:

Area CodePhone Number
Alternate phone number:

Area CodePhone Number
Cell phone:

Area CodePhone Number
Email address:
How did you hear about KETCH?
If "Internet" was marked above, what was the site?
Specific position applying for:
Date you could start:
Prefer:
Days available:
Times available on Monday
Times available on Tuesday
Times available on Wednesday
Times available on Thursday
Times available on Friday
Times available on Saturday
Times available on Sunday
Are you 18 years of age or older?
Are you either a US citizen or alien authorized to work in the United States?
Have you been convicted of a felony or released from prison in the past 10 years?
If "Yes", please explain:
Are you involved with an unresolved criminal charge?
If "Yes", please explain: (a yes answer will not automatically disqualify you from employment.)
High School/GED Name: Must be accredited; Proof is required if hired
High School/GED Location:
High School Diploma/Degree?
Technical School Name:
Technical School Location:
Technical School Diploma/Degree?
Technical School Major:
College School Name:
College School Location:
College Diploma/Degree?
College Major:
Do you have all licenses and certifications required to perform the job(s) for which you have applied?
If no, please explain:
If you are applying for a position that involves driving on the job, do you have a valid driver's license? NOTE: Satisfactory driving record may also be required for the position.
Driver's license #:
Describe any specialized training, knowledge, or other skills (such as CPR, First Aid, Mandt, sign language):
Have you ever worked for this company before?
If yes, list dates:
EXPERIENCE #1

Please list all previous employment for the past 10 years. Begin with your last or present employment.
Employer:
Address:
Job Title:
Job Duties:
Phone Number:
Supervisor:
Dates Employed: From:
Dates Employed: To:
Reason for Leaving:
EXPERIENCE #2
Employer:
Address:
Job Title:
Job Duties:
Phone Number:
Supervisor:
Dates Employed: From:
Dates Employed: To:
Reason for Leaving:
EXPERIENCE #3
Employer:
Address:
Job Title:
Job Duties:
Phone Number:
Supervisor:
Dates Employed: From:
Dates Employed: To:
Reason for Leaving:
EXPERIENCE #4
Employer:
Address:
Job Title:
Job Duties:
Phone Number:
Supervisor:
Dates Employed: From:
Dates Employed: To:
Reason for Leaving:
Do you have any experience from your military service that would be relevant to the job for which you are applying?
If yes, please explain:
REFERENCES

Give 3 work/professional references who are not related to you.
Name #1:
How do you know this person?
Daytime Phone Number:

Area CodePhone Number
Name #2:
How do you know this person?
Daytime Phone Number:

Area CodePhone Number
Name #3:
How do you know this person?
Daytime Phone Number:

Area CodePhone Number
Resume (Optional)
Please upload your resume here

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I certify that answers given herein are true and complete to the best of my knowledge. Any job offer may be conditioned upon the applicant passing a drug screen. KETCH also has a policy of testing existing employees under various circumstances. Job offer may also be contingent upon satisfactory record checks including but not limited to criminal background, DCF Abuse and Neglect Registry, and motor vehicle records (for positions requiring a drivers license). I hereby authorize my present and previous employers and listed references to release to KETCH any and all records of my service and other information concerning me; except that which would indicate age, race, creed, color, sex, ancestry, or national origin. Further, I hereby release these parties from all liability for damage, except that resulting from misrepresentation which might result from furnishing the information. I hereby acknowledge that any employment relationship with this company is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of the company. In the event of my employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
After submitting form, please scroll to top of page for confirmation. If you have any question or issues with the online job application, please call (316) 383-8777.
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KETCH APPLICATION FOR EMPLOYMENT 1006 E Waterman, Wichita, KS 67211

EXPERIENCE #1

EXPERIENCE #2

EXPERIENCE #3

EXPERIENCE #4

REFERENCES

Resume (Optional)

After submitting form, please scroll to top of page for confirmation. If you have any question or issues with the online job application, please call (316) 383-8777.