STANDARD APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

PLEASE COMPLETE THE APPLICATION BELOW

We are a DRUG-FREE workplace. Complete all sections thoroughly. A résumé may be attached but may not substitute for completion of the application.

UPLOAD RÉSUMÉ

By typing your name, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.


FILL FORM

PRINT NAME

ADDRESS

PREVIOUS THREE YEARS RESIDENCY


POSITION(S) APPLIED FOR

(Verification of your legal right to work in the United States will be required within three days of being hired.) 


RECORD OF EDUCATION


Please include name and address of school and under what name attended, if different.

HIGH SCHOOL

COLLEGE

OTHER


REFERENCE


List two references, home telephone numbers and years known. (Do not include relatives or employers.)



EMPLOYMENT RECORD

(ATTACH SHEET IF MORE SPACE IS NEEDED)


Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information for all employers you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record).

Must list the complete mailing address: street number, street name, city, state and zip code.

LAST EMPLOYER

SECOND LAST EMPLOYER

THIRD LAST EMPLOYER


TO BE READ AND SIGNED BY APPLICANT


I authorize you to make sure investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.


In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.


“I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

  • Review information provided by current/previous employers;
  • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
  • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.”

By typing your name, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.

Note: A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations.


LICENSE INFORMATION


Have a rebuttal statement attached to the alleged erroneous information, if theSection 383.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license”. I certify that I do not have more than one motor vehicle license, the information for which is listed below


EMPLOYMENT CONDITIONS — READ CAREFULLY BEFORE SIGNING


By my signature below, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, any falsified statements on this application shall be grounds for dismissal. Under the provisions of the Fair Credit Reporting Act, the Americans With Disabilities Act, the Drivers Privacy Protection Act and all other applicable federal, state, and local laws I authorize investigation of all statements contained herein as well as authorize the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise.


I hereby release and hold harmless any person, firm, or entity that discloses information in accordance with this authorization, as well as my prospective employer, and its agents, from any liability that may otherwise result from the request for, use of, or disclosure of, any or all of the foregoing information. The above-mentioned investigations may include, but are not limited to, information as to my character, general reputation, work history, or lifestyle, discerned through employment and education verifications; personal references; personal interviews; my personal credit history based on reports from any credit bureau; my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history records; or any other public record.


I hereby provide consent to Kimbro Oil Company to conduct a limited query of the FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse (Clearinghouse) to determine whether drug or alcohol violation information about me exists in the Clearinghouse. The terms of the consent are for limited and full queries for the duration of employment or for preemployment measures. I understand that if the limited query conducted by Kimbro Oil Company indicates that drug or alcohol violation information about me exists in the Clearinghouse, FMCSA will not disclose that information to Kimbro Oil Company without first obtaining additional specific consent from me. I further understand that if I refuse to provide consent for Kimbro Oil Company to conduct a limited query of the Clearinghouse, Kimbro Oil Company must prohibit me from performing safety-sensitive functions, including driving.


I understand that consumer reports which may contain public record information may be requested, at the discretion of my prospective employer, which may include names, dates of employment, reason for termination, work experience, traffic records, workers compensation claims, etc. I have the right, under the provisions of the Fair Credit Reporting Act and the Drivers Privacy Protection Act to request all such information from the reporting agency, upon proper identification, and to request the nature and substance of all information; and the receipt of any reports on me, which the reporting agency has, or will, furnish for the two preceding years. I am also entitled to a copy of my consumer rights under the Fair Credit Reporting Act. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.


I understand that employment with Kimbro Oil Company is “at will” and therefore for an indefinite period of time. If employed, I may terminate my employment at any time and Kimbro Oil Company may terminate or modify the employment relationship at any time with or without notice or cause. I understand that I am not guaranteed a specific shift, schedule or work assignment and I may be expected to work overtime. If employed by Kimbro Oil Company, I will abide by its rules, regulations, policies and procedures. I understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.


Finally, I freely and voluntarily agree to undergo drug testing as part of the application process, or at any time during my employment with Kimbro Oil Company. I understand that either refusal to submit to the test or failure of the test per Kimbro Oil Company policy will disqualify me from consideration and/or continuation of employment.


By typing your name, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.



Kimbro Oil Company is an Equal Opportunity Employer and does not discriminate on the basis of race, color, age, sex, religion, national origin, disability, marital status, or any other characteristic protected by law. Kimbro Oil Company is a non-smoking facility in compliance with the Tennessee Non-Smoker Protection Act.