KFC Application Form

Personal Details

Name *

Email *

Phone *

NIS# *

D.O.B *

Address

Emergency Contact Information

Name

Relationship

Phone#

Mobile#

Address

Employment Information

Position Desired

Can you perform the essential functions of the position for which you are applying

If No, please explain

When would you be able to begin work?

Salary expectation?

Eligibility for employment in St. Lucia

Have you ever worked under another name?

If yes, what was it and what was the reason for the change?

Have you ever been convicted of a felony or misdemeanour in the last seven years?

Have you ever been accused of being dishonest in any previous employment?

If Yes, please explain

Have you ever worked for the company before?

If Yes, where?

Employment History

Name of company

Phone#

Supervisor Name & Title

Address

Dates Employed

From

Rate of pay

Starting

Ending

Position held

Reasons for leaving

Duties

Education

School

Name and location of institution

Course of study

Start Date

End Date

Diploma/Degree

College/University

Name and location of institution

Course of study

Start Date

End Date

Diploma/Degree

Vocational

Name and location of institution

Course of study

Start Date

End Date

Diploma/Degree

Graduate Work

Name and location of institution

Course of study

Start Date

End Date

Diploma/Degree

Have you completed any additional special courses, seminars and/or training that would enable you to perform in the position for which you are applying?

If Yes, please describe?

Do you suffer from any medical condition/allergy which may restrict your ability to perform in this position?

If Yes, please describe?

Do you have any commitments that would restrict your hours/days of work?

If Yes, please describe?