Please fill out the following form for employment.

Name: *
Address: *
E-mail: *
Phone: *
Are you under 18?
If not over 18 can you provide a work permit or proof of graduation from high school or equivalent
Have you ever been employed by Kirin *
Can you, after employment submit verification of your legal right to work in the U.S. *
How were you referred
What position are you applying for *
Date you can begin *
What time can you work *
Do you know the general function of the job which you are applying for *
What are your qualifications or skills for this position
Highest Education Completed *
School Name
School Address:
Course of study

Previous Employment
Company Name
Company Address:
Company Phone:
Job Title / Position Held
Date Started
Date Ended

Previous Employment
Company Name(1)
Company Address:(1)
Company Phone:(1)
Job Title / Position Held(1)
Date Started(1)
Date Ended(1)

Previous Employment
Company Name(2)
Company Address:(2)
Company Phone:(2)
Job Title / Position Held(2)
Date Started(2)
Date Ended(2)

Previous Criminal Record
Have you ever been convicted of a felony *
Conviction of a crime will not absolutely prohibit employment with us, but will be considered based upon the position for which you are applying.
If "Yes" provide description and dates

Applicants Statement
Please read carefully: By submitting below, I certify that misrepresentation or omissions in this application or in other information I give to Kirin, orally or in writing, may be cause for rejection or may be cause for subsequent dismissal if I am hired. I authorize investigation of the statements herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information such references may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I understand that if the Company decides to engage an investigative consumer reporting agency to report on my credit and personal history, the Company will provide me, at my request, with the name and address of the agency so that I can obtain from them the nature and substance of the information contained in the report. If I am employed, I understand that my employment is "at will" and for no definite period of time. Either Kirin or I may terminate my employment at any time, with or without cause and with or without notice. I further understand that my employment is at will regardless of any statement made by a Kirin agent or employee or in a Kirin policy, practice, handbook, program, or any other written or oral materials.I understand that no representatives of Kirin other than the President of Kirin have the authority to make arrangements with me concerning the length of my employment. Such agreements must be in writing and signed by the President of Kirin.