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    Employment Application

    Confidential Experience History of:

    We are dedicated to a policy of non-discrimination in employment on the basis of race, color, age, sex, religion, national origin, marital status, or the presence of any physical, mental or sensory handicap.


    BUSINESS EXPERIENCE: Please start with your present or last position. 



    Here, summarize those achievements and experiences which you consider to be important in terms of your qualifications for a more responsible position.


    In the event of an emergency, whom would you wish notified (other than spouse)


    Is there any reason which might impact your ability to perform the essential duties of the job(s) for which you have applied which you feel the company should take into account in determining job placement? If you have any questions about the "essential duties" of the job in question, please ask us



    (Exclude those which indicate race, color, religion, sex, national origin, or marital status.)


    I certify that the information given by me to Kenworth Northwest, Inc. is true and complete to the best of my knowledge. I understand that, if I am employed, discovery that I omitted information or gave false or misleading information may result in immediate dismissal.

    I authorize Kenworth Northwest Inc. to solicit information regarding my character, general reputation, credit, previous employment, and similar background information, and to contact any and all references I have given on my application. I hereby release all parties and persons connected with any such request for information from all claims, liabilities, and damages arising out of the furnishing of such information. If employed, I release Kenworth Northwest, Inc. from any liability for future references it may provide regarding my work history at the firm. I understand that an investigative consumer report may be obtained through personal interviews with my neighbors, friends, or associates. If I am refused employment on the basis of such a report upon written request from us within a reasonable time, I have the right to a complete and accurate disclosure of the nature and scope of the investigations requested by Kenworth Northwest, Inc.

    In, consideration of my employment, I agree that my employment and compensation can be terminated with or without cause, and with or without notice at any time, at the option of either Kenworth Northwest, Inc. or myself. I understand that no representative of Kenworth Northwest, Inc. other than the President has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.

    If employed, I further agree that if Kenworth Northwest, Inc. advances any paid leave before it has been accrued, or advances or loans me any money during the course of my employment, or if I lose, damage, or fail to return any firm property, the firm is authorized to deduct from my wages sufficient funds to repay such loads or advances or to replace its property.



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