Employment Application

Ornamental Fencing - black ornamental steel, vinyl coated chain link, vinyl privacy fence - Primrose School at KU Medical Center - Kansas City, Kansas

Employment Application

An Equal Opportunity Employer

You will be considered for all positions without regard to race, color, religion, weight, height, sex, national origin, marital status, veteran status, the presence of a non-job-related medical condition, handicap, or any other protected status required by law.

Personal Information

Proof of citizenship or immigration status will be required upon employment.


High School

Military Status

Employment History

If records are under a different name, please provide name for reference purposes, starting with present of last employer. List all employment including part-time or temporary positions.

Employer 1
Employer 2
Employer 3
Employer 4


Give the name, address and phone number of three references not related to you.

Reference 1
Reference 2
Reference 3

Driver Information

Experience and Qualifications

Drivers Licenses
Drivers Licenses
Drivers Licenses
Driving Experience

Driving Experience

Driving Experience

Accident Record

Accident 1
Accident 2
Accident 3

Traffic Convictions

List all convictions and forfeitures for the past 3 years (other than parking violations).

Conviction 1
Conviction 2
Conviction 3

I understand that by law, the company requires all persons applying for positions as truck drivers of vehicles 26,001 pounds or more, to undergo a pre-employment drug test. I understand that refusal to undergo this test will be considered as a withdrawal of my application. I also understand that if the test discloses the presence of an illegal foreign substance, I will be denied employment.

This application for employment is to be read and signed by applicant. This certifies that this application was completed by the applicant, and that all entries and information on it are true and complete to the best of the applicant’s knowledge.