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Application for Work

[all fields are required]

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(list employers, starting with the most recent.  Explain all gaps in time of employment.  Fill section out carefully and completely)

Present Employer:

Past Employer - 1:

Past Employer - 2:

Past Employer - 3:


By clicking SUBMIT below you agree to the following statement:


"I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements to this application shall be grounds for dismissal, and I agree to hold my employer harmless in the event of my dismissal based thereon.


I authorize investigation of all statements contained herein and to do background checks to give you any and all information concerning my previous employment and any pertinent information that may have, confidential or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you."


I understand that it is a company policy of Kevin Kent Const. LLC that all prospective employees submit to a controlled substance test involving the collection of a urine sample that will be tested for the following controlled substances:

Marijuana, cocaine, opiates, amphetamines, and phencyclidine (PCP).


I understand that if I test positive for the use of controlled substances that I will be given a reasonable opportunity to confer with the company’s medical review officer before any positive result is reported to the company.


The results of the drug tests will be maintained by the medical review officer of the company who will report to Kevin Kent Const. LLC whether the test result was negative or positive.  The results of any tests will not be released to any additional parties without my written authorization.


[applications are kept on file for 6 months]

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