Camper Center - Pocomoke City, MD - Ken-Do's RV Repair Service

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.

Position(s) applied for

Date of Application

Referral Source

Other

Name of Source (if applicable)

Name

Last

First

Middle

Address

Street

City

State

Zip Code

Telephone #

Other Phone #

E-mail Address

If necessary, best time to call you at home is

If you are under 18 and it is required, can you furnish a work permit?

Yes

No

Have you submitted an application here before?

Yes

No

If yes, give date(s) and position(s)

Have you ever been employed here before?

Yes

No

If yes, give dates

From

To

Are you legally eligible for employment in this country?

Yes

No

Date available for work

What is your desired salary range?

Type of employment desired

Will you relocate if job requires it?

Yes

No

Will you travel if job requires it?

Yes

No

Are you able to meet the attendance requirements of the position?

Yes

No

Will you work overtime if required?

Yes

No

If no, please explain

Have you ever been bonded?

Yes

No

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?

Yes

No

If yes, please provide date(s) and details

ANSWERING "YES" TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND POSITION APPLIED FOR WILL BE TAKEN INTO ACCOUNT.

Answering "yes" to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

State

AN EQUAL OPPORTUNITY EMPLOYER

An Equal Opportunity Employer

Employment History

Employment History

Provide the following information of your past and current employers, assignments or volunteer activities, starting with the most recent (use additional sheets if necessary). Explain any gaps in employment in comments section below.

Employer

Telephone#

DATES EMPLOYED

Dates Employed

From

To

Summarize the Type of Work Performed and Job Responsibilities

Address

Starting Job Title / Final Job Title

Hourly Rate/salary

Starting

$

Per

FINAL

Final

$

Per

Immediate Supervisor and Title

Reason for Leaving

May We Contact for Reference?

Yes

No

Later

Employer

Telephone#

DATES EMPLOYED

Dates Employed

From

To

Summarize the Type of Work Performed and Job Responsibilities

Address

Starting Job Title / Final Job Title

Hourly Rate/Salary

Starting

$

Per

FINAL

Final

$

Per

Immediate Supervisor and Title

Reason for Leaving

May We Contact for Reference?

Yes

No

Later

Employer

Telephone#

DATES EMPLOYED

Dates Employed

From

To

Summarize the Type of Work Performed and Job Responsibilities

Address

Starting Job Title / Final Job Title

Hourly Rate/salary

Starting

$

Per

FINAL

Final

$

Per

Immediate Supervisor and Title

Reason for Leaving

May We Contact for Reference?

Yes

No

Later

Employer

Telephone#

DATES EMPLOYED

Dates Employed

From

To

Summarize the Type of Work Performed and Job Responsibilities

Address

Starting Job Title / Final Job Title

Hourly Rate/salary

Starting

$

Per

FINAL

Final

$

Per

Immediate Supervisor and Title

Reason for Leaving

May We Contact for Reference?

Yes

No

Later

Comments

Including Explanation of Any Gaps in Employment

Skills and Qualifications

Skills and Qualifications

Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

Educational Background (if job related)

Educational Background (if job related)

A. List last three (3) schools attended, starting with most recent. B. List number of years completed. C. Indicate degree or diploma earned, if any. D. Grade Point Average or Class Rank. E. Major field of study. F. Minor field of study (if applicable).

A. School

A. School 2

A. School 3

B. Number of Years Completed

B. Number of Years Completed 2

B. Number of Years Completed 3

C. Degree Diploma

C. Degree Diploma 2

C. Degree Diploma 3

D. GPA Class Rank

D. GPA Class Rank 2

D. GPA Class Rank 3

E. Major

E. Major 2

E. Major 3

F. Minor

F. Minor 2

F. Minor 3

References

References

List name and telephone number of three business/work references who are NOT related to you and are NOT previous supervisors. If not applicable, list three school or personal references who are not related to you.

Name

Name 2

Name 3

Telephone

Telephone 2

Telephone 3

Number of Years Known

Number of Years Known 2

Number of Years Known 3

Additional Information

Additional Information

List Professional, Trade, Business or Civic Associations and Any Offices Held. Exclude Memberships that Would Reveal Race, Color, Religion, Sex, National Origin, Citizenship, Age, Mental or Physical Disabilities, Veteran/reserve National Guard or Any Other Similarly Protected Status.

List professional, trade, business or civic associations and any offices held.

Exclude Memberships that Would Reveal Race, Color, Religion, Sex, National Origin, Citizenship, Age, Mental or Physical Disabilities, Veteran/reserve National Guard or Any Other Similarly Protected Status.

Organization

Organization 2

Organization 3

Organization 4

Offices Held

Offices Held 2

Offices Held 3

Offices Held 4

List special accomplishments, publications, awards, etc.

Exclude Memberships that Would Reveal Race, Color, Religion, Sex, National Origin, Citizenship, Age, Mental or Physical Disabilities, Veteran/reserve National Guard or Any Other Similarly Protected Status.

List any additional information you would like us to consider.

Applicant Statement

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law. I understand that this application remains current for only 6 months. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview.

I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 6 months. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

Do Not Sign until You Have Read the Above Applicant Statement.

Do Not Sign until You Have Read the Above Applicant Statement.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Signature of Applicant

Date

Application Employment

From mobile roadside assistance to motor home sales, call Ken-Do's RV Repair Service in Pocomoke City, MD, at (410) 957-2500 now!

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