APPLICATION FOR EMPLOYMENT
We appreciate your interest in employment opportunities with Kana Pipeline, Inc.. Kana Pipeline, Inc. is an Equal Employmentemployer. Company policy prohibits unlawful discrimination against any applicant or employee on the basis of race, color, sex, religion,national origin, age, disability, or any other basis protected by applicable federal, state, or local laws. The Company also prohibitsharassment of applicants and employees based on any of these protected categories.
Note to Applicants: Smoking is prohibited in all indoor areas of the Company unless designated smoking areas have been establishedby a particular office in accordance with applicable State and local law.
Have you ever used any other name(s) which is (are) necessary forus to know in order for us to verify your employment or educationalrecord?
Have you previously worked for or applied for a position withKana Companies, in any of our offices either as an employee orthrough an employment agency?
If yes, please explain when and, if employed, in what capacity:
Date Availablefor Work
Are you at least 18 years old?
Are you available to work overtime as needed?
Do you have any relatives now employed at Kana Companies?
If yes, state name(s) and where they are located.
P E R M I S S I O N T O W O R K
If hired, can you present evidence of your legal right to work in the US?
R E F E R R A L I N F O R M A T I O N
How did you learn about Kana Pipeline, Inc.?
Employment Agency (state name):
Reputation of Company:
Referral (state name):
School (state name):
Newspaper ad (name of paper):
W O R K E X P E R I E N C E
Please specify your complete full-time and part-time employment history, including self-employment. You may include any verifiedwork performed on a volunteer basis. Begin with your most recent employer. If you require additional space, please use the reverseside of this page and/or the following page.
Name, Title, and Phone Number of Supervisor
Job Title, and Work Responsibilities
Employed (Month and Year)
Reason for Leaving:
Please explain any gaps in your employment
All employers including your current employer may be contacted to verify the information you provide. May we contact yourcurrent employer prior to making an offer of employment? Yes No
P R O F E S S I O N A L R E F E R E N C E S
Individuals not related to you. Business references preferred
Years Knownand Capacity
E D U C A T I O N & T R A I N I N G
Please include name, street, city, state and zip code for each school.
Name and Location of School
General Office Skills
List any other office/business skills you possess which are relevant to the positionyou seek:
Software and Technology
Check only those with which you are proficient.For those marked with an (*), provideinformation as to the specific version, release,or model.
Electronic Mail Programs*
Litigation Support Programs*
Document Management Programs*
List any other software programs with whichyou are proficient, and any other technical skillsyou possess:
Do you have any other experience, skills, or qualifications which you feel would benefit Kana Pipeline, Inc.? If so, please explain:
Are you able to perform the essential duties of the position for which you are applying, either with or without reasonableaccommodations? ˜ Yes ˜ No If necessary, please indicate what type(s) of reasonable accommodations are needed:
A D D I T I O N A L E M P L O Y M E N T I N Q U I R I E S
If applying for a position that will include driving:
Driver’s License Information: State: Number: Expiration Date:Restrictions or Suspensions (respond fully if driving is required by the job for which you are applying):If hired, you may be required to provide proof of insurance coverage
A P P L I C A N T ’S S T A T E M E N T & A C K N O W L E D G M E N T
THIS APPLICATION IS NOT COMPLETE UNTIL IT IS FULLY COMPLETED, SIGNED, ANDALL STATEMENTS BELOW HAVE BEEN READ AND INITIALED.
My signature below certifies that I agree to be bound by the terms and conditions stated in this Application, which contains all theunderstandings between Kana Pipeline, Inc. and me concerning the topics addressed herein, and supersedes any and all priorinconsistent understandings between Kana Companies and me on such issues.
Leave this empty:
If you have questions about the contents of this document, you can email the document owner.
Document Name: Careers
Agree & Sign