Employment Application

Employment Application

Federal law prohibits discrimination in hiring or employment on the basis of race, color, sex, religion, disability, national origin, citizenship, or on the basis of age. No question on this application is intended to secure information to be used for such discrimination. Proof of identity and work authorization will be required upon employment in accordance with federal regulations. KEENAN ENERGY plans to verify the accuracy of the statements you make on this application. This application will receive consideration for sixty (60) days. If you have not heard from KEENAN ENERGY within sixty days and wish to receive further consideration for employment, you must reapply in person.






(beginning with the last or present employer first)

Criminal Background

(A “yes” answer will not automatically disqualify you from consideration.)

Driving Information

Please list all moving traffic violations in the past five (5) years

Special Skills

Relatives In Our Employment

list any relatives you have that currently work for Keenan Energy


Give three references who are not relatives or former employers.

Reference 1

Reference 2

Reference 3


I authorize, without liability, investigation of all statements in this application. I authorize all schools which I attended and all previous employers to furnish to KEENAN ENERGY my record, reason for leaving and all information they may have concerning me, and I hereby release them and KEENAN ENERGY from all liability for any damage whatsoever arising wherefrom.

I understand that KEENAN ENERGY may investigate my driving record, criminal record, and credit history. I understand I may be notified if such an investigative report is obtained and that I will have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of information concerning the nature and scope of the investigation.

Following an offer of employment, and, as a continuing condition of employment should I be hired, KEENAN ENERGY may require that I submit to a medical examination.  KEENAN ENERGY also reserves the right to require me to undergo drug testing prior to employment or at any time during my employment, to the extent permitted by law.

I understand that in event of my employment by KEENAN ENERGY,, it shall be sufficient cause for dismissal if any of the information I have given in this application is false, misstated, or if I have failed to give any information herein requested. I understand that proof of identity and work authorization will be required upon employment in accordance with federal regulations. In event of my employment by KEENAN ENERGY ., I agree to abide by all present and subsequently issued rules of the Company.

If I am employed, I agree that my employment with KEENAN ENERGY is at will of the Company, which means that KEENAN ENERGY has the right to discharge me for any reason whatsoever.  I also understand that I may be terminated or laid off at the discretion of the Company.  I expressly agree and understand that this is the entire agreement between KEENAN ENERGY and myself on the subject of discharge, termination and/or laid off, and it may be changed only by an agreement in writing, signed by the President of the Company.  I agree to conform to the Company’s rules, and I also agree that I shall be subject to other conditions which KEENAN ENERGYmay adopt at its sole discretion.

I affirm that the information on this application is true and complete.

I understand and agree that, if hired, my employment is “at will.”  This means that either I or the Company may end the employment relationship at any time and for any or no reason.


This application form is also available as a printable pdf file.

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