Attn: Human Resources
7724 E. Panama Lane
Bakersfield, CA 93307-9210
Email: /
APPLICATION FOR EMPLOYMENT
If not completing electronically, please type or print using black or dark blue ink.Equal Opportunity Employer
PERSONAL
LAST / FIRST / MIDDLE
FULL NAME
NUMBER / STREET / CITY / STATE / ZIP CODE / TELEPHONE NUMBERS WITH AREA CODES
PRESENT ADDRESS
NUMBER / STREET / CITY / STATE / ZIP CODE / E-MAIL ADDRESS
PERMANENT ADDRESS
(if different)
HAVE YOU EVER APPLIED TO OR INTERVIEWED WITH KERN OIL & REFINING CO.? / YES / NO / IF “YES,” GIVE THE APPROXIMATE DATE(S)
HAVE YOU EVER PERFORMED WORK FOR KERN AS AN INDIVIDUAL CONTRACTOR OR AN EMPLOYEE OF A CONTRACTOR? / YES / NO / IF “YES,” LIST THE COMPANY AND LOCATION AND APPROXIMATE DATE(S)
DO YOU HAVE A VALID DRIVER’S LICENSE, AND CAN YOU PRESENT A GOOD DMV REPORT? / YES / NO / IF “NO,” EXPLAIN
FOR REFERENCE PURPOSES – IF YOU HAVE EVER USED ANOTHER NAME, STATE NAME AND DATES / REFERRED TO KERN BY:
IF YOU HAVE ANY WORK LOCATION RESTRICTIONS, EXPLAIN:
Do you have the unrestricted right to work in the United States? / YES / NO / Will you need the Company's sponsorship to continue or extend your current work authorization status? / YES / NO
Have you ever been convicted of a felony or misdemeanor? (Do not Provide information on misdemeanor marijuana convictions more than two years old). Convictions will not necessarily disqualify an applicant from employment. / YES / NO / If yes, please provide details:
Are you currently under arrest for any crime, other than for possession of less than one ounce of MARIJUANA MORE than two years ago, THAT has not been resolved (i.e. pending trial, out on bail or on own RECOGNIZANCE, etc.)? / YES / NO / If yes, please provide details:
Are you ABLE TO PERFORM THE ESSENTIAL FUNCTIONS OF THE JOB
FOR WHICH YOU ARE APPLYING WITHOUT REASONABLE ACCOMODATIONS? / YES / NO / IF YOUR ANSWER IS “NO”, PLEASE ADVISE IN THIS SPACE WHAT ACCOMMODATIONS WOULD BE NEEDED.
EMPLOYMENT INTERESTS
FULL TIME / TEMPORARY / PART
TIME / SUMMER / DATE AVAILABLE FOR EMPLOYMENT
POSITION APPLYING FOR – INDICATE SPECIALTY AREAS OF TRAINING & EXPERIENCE THAT YOU COULD APPLY:
FOR OFFICE SUPPORT POSITIONS ONLY / TYPING / LIST COMPUTER SOFTWARE/EQUIPMENT WITH WHICH YOU ARE FAMILIAR
WPM
EDUCATION
SCHOOL NAME / TYPE OF
DEGREE
GRANTED
OR
EXPECTED / GRADE POINT AVERAGE
e.g. 3.2/4.0
MAJOR / OVERALL
HIGH SCHOOL / DIPLOMA
or G.E.D. / Yes / No
COLLEGE/UNIVERSITY / MAJOR SUBJECT
OTHER / MAJOR SUBJECT
SCHOLASTIC HONORS (FELLOWSHIPS, PRIZES, SCHOLARSHIPS, ETC.). EXPLAIN EACH
EMPLOYMENT
POSITION HELD
(LIST JOB TITLE AND DESCRIBE
DUTIES BRIEFLY)
1. PRESENT OR LAST EMPLOYER / DATES / From (Mo. & Yr.)
To (Mo. & Yr.)
NO. / STREET / CITY / STATE / ZIP / REASON FOR LEAVING
TELEPHONE – AREA CODE AND NUMBER / SUPERVISOR
Final Wages / Salary / Hr Wk Mo
2. PREVIOUS EMPLOYER / DATES / From (Mo. & Yr.)
To (Mo. & Yr.)
NO. / STREET / CITY / STATE / ZIP / REASON FOR LEAVING
TELEPHONE – AREA CODE AND NUMBER / SUPERVISOR
Final Wages / Salary / Hr Wk Mo
3. PREVIOUS EMPLOYER / DATES / From (Mo. & Yr.)
To (Mo. & Yr.)
NO. / STREET / CITY / STATE / ZIP / REASON FOR LEAVING
TELEPHONE – AREA CODE AND NUMBER / SUPERVISOR
Final Wages / Salary / Hr Wk Mo
4. PREVIOUS EMPLOYER / DATES / From (Mo. & Yr.)
To (Mo. & Yr.)
NO. / STREET / CITY / STATE / ZIP / REASON FOR LEAVING
TELEPHONE – AREA CODE AND NUMBER / SUPERVISOR
Final Wages / Salary / Hr Wk Mo
ADDITIONAL INFORMATION
MAY WE CALL YOUR PRESENT EMPLOYER NOW? / WHEN REQUIRED BY THE JOB, ARE YOU WILLING TO WORK:
YES / NO / IF “NO,” WHEN MAY WE CALL?
WEEKENDS / YES / NO / SHIFTS
(Including 12-Hrs) / YES / NO
BRANCH OF U.S. MILITARY SERVICE / HIGHEST RANK / LENGTH OF ACTIVE SERVICE / MILITARY OCCUPATIONAL SPECIALTY
“X” IF LEFT MILITARY SERVICE WITHIN THE LAST 2 YEARS / 8
Please indicate if you or your spouse have any close relatives who are employed by KERN or its customers. For this purpose, a “close relative” shall include any of the following: spouse, father, mother, brother, sister, son, daughter, grandparent, grandchild, uncle, aunt, nephew, or niece, including in connection with each, “step,” “in-law,” or “half” relationships. If you answer yes, please identify. / YES
NO
Name: / Location: / Relationship:
Please identify an emergency contact person:
Name: / Contact Phone / Relationship:
CONDITIONS
I authorize Kern Oil & Refining Co. to verify all statements contained in this application for employment and to make any necessary reference checks except as limited above for present employer.
I understand that employment is contingent upon meeting the physical requirements of the job, and satisfactory results from drug testing. I understand and agree that if I am offered a position, it will be offered on condition that my employment shall be at will and for no definite period, and that my employment may be terminated at any time with or without cause and with or without prior notice. I understand that, except for the President of Kern Oil & Refining Co., no supervisor or manager may alter or amend the above conditions. Only the President of the company has authority to make any agreement contrary to the foregoing and such agreement must be in writing and signed by the President.
I understand and agree that during the hiring process, or upon employment, as appropriate, I may be asked to furnish proof of my identity; proof of U.S. citizenship or proof that I may legally accept such employment; proof of date of birth; military discharge forms; and appropriate academic transcripts. Also, I realize it will be necessary to sign receipt of Kern’s Employment Practices document that contains several policies including the “Employee Intellectual Property and Confidential Information Agreement” that includes statements on inventions, conflicts of interest, processes, proprietary and confidential information.
I certify that all statements I have made in this application are true and agree that any misrepresentation or omissions of facts called for may result in cancellation of my application for employment or immediate dismissal.
SIGNATURE OF APPLICANT / DATE
Note: If you submit this application electronically, your submission will be considered to represent your signature. You will be asked to provide an original signature at the time of interview or hire.
Rev: Jan 2012
Kern Oil & Refining Co.
Attn: Human Resources
7724 E. Panama Lane
Bakersfield, CA 93307-9210
Voluntary Equal Employment Opportunity Form
The following information relating to gender and race/ethnic origin is collected consistent with Federal and State agency regulations.
Completion of this form is entirely voluntary and information contained on it shall be used solely for statistical purposes. This form will not be made available to any decision-making individual involved in the hiring process, and will be kept in a separate file. Information on this form, or a decision not to complete this form, will not be considered in any employment decision.
- Name:
- Date of Application:
3. Position(s) applied for:
4. Race/ Ethnic background:
White (Not of Hispanic origin) – All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East
Black (Not of Hispanic origin) – All persons having origins in any of the Black racial groups of Africa
Hispanic – All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race
Asian or Pacific Islander – All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa
American Indian or Alaskan Native – All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition
5. Gender:
Male Female