10934 East 55th Place

Tulsa, OK 74146

918-794-9494

support@kgmgas.com

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For downloadable/printable application CLICK HERE.

Applicant Information
First Name*
Middle Name*
Last Name*
Address*
Apartment/Unit #
City*
State*
Zip*
Phone*
Email*
Date Available*
Position Applied For*
DesiredSalary
Are you a citizen of the United States?*
 Yes   No
If no, are you authorized to work in the US?
 Yes   No
Have you ever worked for this company?*
 Yes   No
If yes, when?
Have you ever been convicted of a felony?*
 Yes   No
If yes, explain
Education
High School
Address
From  To
Did you graduate?  Yes   No
Diploma
College
Address
From  To
Did you graduate?  Yes   No
Diploma
Other
Address
From  To
Did you graduate?  Yes   No
Diploma
References
Please list three professional references
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Previous Employment
Company
Phone
Address
Supervisor
Job Title
From
To
Responsibilities
Reason for leaving
May we contact your supervisor for a reference?
 Yes   No
Company
Phone
Address
Supervisor
Job Title
From
To
Responsibilities
Reason for leaving
May we contact your supervisor for a reference?
 Yes   No
Company
Phone
Address
Supervisor
Job Title
From
To
Responsibilities
Reason for leaving
May we contact your supervisor for a reference?
 Yes   No
Military Service
Branch
From
To
Rank at discharge
Type of discharge
If other than honorable, explain
Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature*

 

Please type the numbers for verification*