KCM Random Screening Survey

"*" indicates required fields

Name*

First Last

Personal Email (Do Not Use AA Email)*

Employee Number*

Phone

Base*

Select the number of consecutive days you are reporting on:*

Example: "In a span of 5 consecutive days I've been selected for 3 random KCM screenings."

How many times have you been chosen as the random at KCM in the above range of consecutive days?*

Example: "In a span of 5 consecutive days I've been selected for 3 random KCM screenings."

Please list the date range:*

Example: 10/12/22-10/20/22, etc.

Location(s) of KCM random screening:

Time (in minutes) to complete the screening:*

APFA Headquarters
1004 West Euless Boulevard
Euless, Texas 76040

M-F: 9:00AM - 5:00PM (CT)
Phone: (817) 540-0108

Contract & Scheduling Desk
M-Th: 9:00AM - 5:00PM (CT)
Phone: (817) 540-0108

Live Chat Messaging
Fridays: 9:00AM - 5:00PM (CT)

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