Employment Application

Applicant Information (* = Required Fields)
Full Name:* Date:  
Last   First   M.I.    
Address:*
Street Address   Apartment/Unit #
City   State   Zip Code  
Phone:*    Email:*
Date Available:*    Desired Salary $:*
Referred By:*
 Position(s) Applied For:*
How did you hear about us?*    Shift Preference*
Desired Work Location(s):*
Kubota Manufacturing of America (KMA) - Gainesville GA Kubota Industrial Equipment (KIE) - Jefferson GA
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States
Yes No
Are you over the age of 18?* 
Have you ever worked for a Kubota Company?*  If yes, please explain?
Have you ever been terminated from employment?*  If yes, please explain?
Have you ever pled guilty to, pled nolo contendere to, or been convicted of a crime other than a minor traffic violation?*
If yes, please explain?
Education (* = Required Fields)
High School: Address:
From: To: Years Completed:
Do you possess a High School diploma or GED?*   Yes   No  

College: Address:
From: To: Did you graduate? Yes    No 
Degree: Years Completed:

Other: Address:
From: To: Did you graduate? Yes    No        Certificate:
Previous Employment (* = Required Fields)
Do you possess 3+ years of verifiable manufacturing experience?*   Yes   No  
Company:* Phone:*
Address:* Supervisor:*
Job Title:* Starting Salary $:* Ending Salary $:*
Responsibilities:*
From:* To:* Reason for Leaving:*
May we contact your previous supervisor for a reference?*   Yes     No 

Company: Phone:
Address: Supervisor:
Job Title: Starting Salary $: Ending Salary $:
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?   Yes    No 

Company: Phone:
Address: Supervisor:
Job Title: Starting Salary $: Ending Salary $:
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference?   Yes    No 
References
Please list three professional references.
Full Name: Relationship:
Company: Phone:
Email:

Full Name: Relationship:
Company: Phone:
Email:

Full Name: Relationship:
Company: Phone:
Email:
Military Service
Branch: From: To:
Rank at Discharge: Highest Rank Achieved:
Disclaimer I understand that Kubota Manufacturing of America and Kubota Industrial Equipment (the "Company") requires certain information about me to evaluate my qualifications for employment and to conduct its business if I become an employee. If I am given a conditional offer of employment, I will be presented a separate, stand-alone consent form which, if signed by me, will authorize the Company to investigate my background, criminal record, credit, educational credentials and other employment related activities. I agree to submit to any drug or alcohol testing which is required to qualify for employment with the Company.

I understand that this application is not an offer of employment and that by accepting my application, the Company does not guarantee that I will be offered a job. I also understand that if I am offered a job, the Company reserves the right to make such changes in the terms and conditions of my employment as the Company determines to be necessary or appropriate.

I understand that an employment with the company would be an employment at-will, meaning my employment would not be for any fixed period of time and that, if employed, I may resign at any time for any reason with or without notice and the Company may terminate my employment at any time for any reason, with or without notice. I further acknowledge my understanding that statements which may be contained in policies, handbooks, and other Company materials do not create any guarantee of employment nor contractual rights, express or implied, and I agree that I will not rely upon them as such. I also understand and agree that such policies may be changed at any time, with or without notice. I further acknowledge that no supervisor, manager, executive or any employee or agent of the Company has the authority to alter any of the above, and that any promises to the contrary will only be relied upon by me if they are in writing and signed by the Company president and myself.

I understand that any false answers or statements made by me on this application or any supplement thereto or in connection with the above-mentioned investigations, regardless of when discovered by the Company, will be grounds for immediate disqualification or discharge, if I am employed. I understand, also, that I am required to abide by all rules and regulations of the Company.

I further understand that any offer of employment may be contingent upon successfully completing a medical evaluation indicating that I am able to perform the essential functions of the job, with or without reasonable accommodation.

I certify that all the above information is true and complete in all respects and that I am submitting this information and any other information during the application process so that the Company can rely on this information in making employment decisions.

NOTE : Kubota provides equal employment opportunity for all qualified persons regardless of race, color, religion, sex, age, national origin, handicap or veteran status.

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