Careers

London-Corbin Airport Board
566 Hal Rogers Drive
London, Kentucky 40744
606-878-9100

APPLICATION FOR EMPLOYMENT

* Indicates required field

Name : *

Address : *

City/State/Zip *

Date *

Phone : *

Are you 18 or older? *

Yes No

EMPLOYMENT DESIRED :

Position : *

Date You Can Start : *

Salary Desired : *

Are You Currently Employed? *

If So, May We Contact Your Current Employer? *

Have You Applied For A Job With Us Before? *

If So, When? *

EDUCATION :

Grade School *

No. of Years Attended *

Did You Graduate? *

High School *

No. of Years Attended *

Did You Graduate? *

College or University *

No. of Years Attended *

Did You Graduate? *

Trade Business, Other *

No. of Years Attended *

Did You Graduate? *

Have You Ever Been Convicted Of A Crime? And If Yes, Please Provide A Brief Description : *

*Applicants may be subject to pre-employment or random drug testing for the following drugs : Marijuana, Cocaine, Opiates, PCP, Amphetamines, Ect.*

Please List Any And All Military Service : *

Rank : *

Present Membership in National Guard or Reserves : *

The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.

FORMER EMPLOYERS : (List below last four employers, starting with the most recent.)

Start Date - End Date *

Name and Address of Employer *

Position and Salary *

Reason for Leaving *

REFERENCES : Give the Names of Three Persons , Not Related To You, WHom You Have Known At Least One Year.

Name *

Address *

Business *

Years Known *

Telephone *

PHYSICAL RECORD :

Do You Have Any Physical Limitations That Prevent You From Any Work For Which You Are Being Considered? *

Yes No

If Yes, What Can Be Done To Accommodate Your Limitation? *

In case of an Emergency, Notify :

Name *

Address *

Telephone *

I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED; FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR IMMEDIATE DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THE 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 AND AGREE THAT, IF HIRED, MY EMPLYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGEDS AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PRIOR NOTICE.

Date *

E-Signature *

Submit