APPLICATION FOR EMPLOYMENT Step 1 of 4 25% Personal InformationApplying For the Position Of Date MM slash DD slash YYYY Referral Source Advertisement Friend Relative Walk-in Name First Last Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address Phone NumberDriver's License Number Have you filed an application here before? Yes No If Yes, Give Date: MM slash DD slash YYYY Do you wish to work: Full Time Part Time Wages expected: Are you employed now? Yes No If Yes, may we contact your present employer? Yes No Date would you be available for work: MM slash DD slash YYYY Are you on lay-off and subject to recall? Yes No Will you undergo a pre-employment examination? Yes No Do you have your own glazing tools? Yes No Would your employment at Kern Glass & Aluminum represent any conflicts of interest? Yes No What languages do you speak fluently? (Read / Write)Person To Notify In Case Of EmergencyName First Last Relationship Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Employment HistoryCompany Name PhoneCompany Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date From MM slash DD slash YYYY Date To MM slash DD slash YYYY Name of Supervisor State Your Job Title & Describe Your WorkReason For LeavingCompany Name PhoneCompany Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date From MM slash DD slash YYYY Date To MM slash DD slash YYYY Name of Supervisor State Your Job Title & Describe Your WorkReason For LeavingCompany Name PhoneCompany Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date From MM slash DD slash YYYY Date To MM slash DD slash YYYY Name of Supervisor State Your Job Title & Describe Your WorkReason For LeavingDo Not ContactWe may contact the employers listed above unless you indicate those you do not want us to contact.EmployerPhone NumberReason EducationSchool Name & LocationHigh SchoolUndergraduate College/UniversityGraduate/ProfessionalLast Grade CompletedHigh SchoolUndergraduate College/UniversityGraduate/ProfessionalDiploma/DegreeHigh SchoolUndergraduate College/UniversityGraduate/ProfessionalDescribe Course of Study/MajorHigh SchoolUndergraduate College/UniversityGraduate/ProfessionalDescribe any specialized training, apprenticeship, skills and extra-curricular activitiesDescribe any honors or awards you have receivedState any additional information you feel may be helpful to us in considering your application ReferencesAt least one (1) references is requiredGive name, email address, telephone number, and address of three references who are not related to you and are not previous employers NameEmailPhone NumberAddress Consent*I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION, I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS, CALLED FOR IS CAUSE FOR DISMISSAL. FURTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PREVIOUS NOTICE. I agree to the privacy policy.EmailThis field is for validation purposes and should be left unchanged. Δ More Info (661) 327-4053California License #202924 Links Employment ApplicationEmployee Access Follow Us FollowFollowFollowFollowFollow Say Hello Contact Us
