Mailing Address: P.O. Box 3127, Brockton, MA 02304

Application Employment Form Page

Employment Application


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    YesNo

    Position Desired





    HourlyMonthlyAnnually

    Full-timePart-time




    WeekendsHolidaysNightsOvertime

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    From
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    Education



    YesNo



    YesNo



    YesNo



    YesNo

    Other education, training, or special skills:

    Skills for Office Position



    YesNo
    PCMac

    Work Experience

    Please list all previous employment, beginning with the most recent. If you need more room, you may attach another sheet of paper.


    From
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    YesNo





    From
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    YesNo




    References

    Identify three persons who know your work, beginning with the most recent.





    Authorization and Acknowledgements

    I affirm that the information I have provided in this application is true to the best of my knowledge, information and belief, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this application is grounds for rejection of my application, and that providing false or misleading information in this application is grounds for discharge.

    I authorize the company to verify my references, record of employment, education record, and any other information I have provided. Unless otherwise noted, I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure.

    Thank you for your interest in employment with Campello-Keith Oil.
    We will keep your application on file and be in touch if an opportunity arises for the position you are interested in.

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