Application For Employment

No question on this application is intended to secure information to be used for a discriminatory purpose, as this company is an equal employment opportunity employer and does not discriminate on the basis of race, color, religion, sex, citizenship, national origin, age, veteran or marital status, disability, or any other legally protected status.
APPLICANT'S STATEMENT OF UNDERSTANDING AND AUTHORIZATION:

I understand that this application will be given every consideration, but its receipt does not imply that the applicant will be employed.

I understand and authorize the company to obtain a consumer report on my financial and credit record as well as an investigative consumer report whereby information is obtained through personal interviews with neighbors, friends and others with whom I am acquainted. This investigation includes information as to my character, general reputation, personal characteristics and mode of living. I understand that I have a right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigative consumer report. I give my permission to the company to contact any of the former employers or references shown below to verify the information I have given and I authorize previous employers to release all records of my employment, including assessments of my job performance, ability and fitness.

I understand that the company may require a Motor Vehicle Record (MVR) report.

I understand that the company reserves the right to require a conditional offer of employment medical examination as well as periodic physical or medical examinations, a pre-employment as well as post-employment drug/alcohol test, to the extent permitted by law. I understand that a polygraph (lie detector) examination, to the extent permitted by law, may be given by the company during employment.

I hereby state that the information given by me in this application is true in all respects, and I agree that if I am employed and the information is found to be false in any respect that I may be dismissed.

Should I be employed I understand that such employment will not result in an employment contract for any specific term.

Signature of Applicant*
Date*
I. PERSONAL DATA
Name*
Social Security No.
Present Address*
City*
State*
Zip*
Previous Address
City
State
Zip
Cell Phone No.*
Are you over the age of 18?*
If no, employment is subject to verification that applicant is of minimum legal age.
- Yes
- No
Are you legally authorized to work in the United States?*
- Yes
- No
Do you have a valid operator's permit (driver's license)?*
- Yes
- No
State*
Driver's License No.*
Expiration Date*
Any restrictions on license?*
- Yes
- No
If yes, please explain:
Have you ever been convicted of a felony, excluding a traffic violation?*
- Yes
- No
A conviction does not automatically mean you will not be offered a job. What you were convicted, the circumstances surrounding the conviction, and how long ago the conviction occurred, are important. Please give all the facts:
Have you ever been convicted of a DWI (Driving While Intoxicated or Driving Under the Influence)?*
- Yes
- No
If yes, give date and details of each conviction:
Have you ever been refused a surety bond?*
- Yes
- No
If yes, state the reason and date:
II. EDUCATION
(List all education and training)
College
Name and Location Major Subjects Diploma/Degree
Business School
Name and Location Major Subjects Diploma/Degree
Vocational
Name and Location Major Subjects Diploma/Degree
High School
Name and Location Major Subjects Diploma/Degree
III. CHARACTER REFERENCES
List Persons Who Know You Well - Not Previous Employers or Relatives*
Name Occupation Phone # # of Years Known
IV. RECORD OF PREVIOUS EMPLOYMENT
List names of employers in consecutive order with current employer listed first. If not currently employed then skip down to previous employer. Account for any gaps and any period of unemployment. If self-employed, give firm name and supply business references.
Current Employer Telephone Employed From Employed To Pay Start Pay Final Employee's Title Name of Last Supervisor Reason for Leaving
*
Previous Employer Telephone Employed From Employed To Pay Start Pay Final Employee's Title Name of Last Supervisor Reason for Leaving
Position(s) applied for:*
Type of employment:*
- Full Time
- Part Time
- Temporary
What days and hours if part-time?
Days Hours
Rate of pay expected?*
Are you presently employed?*
- Yes
- No
If yes, why do you desire to make a change?
Have you been certified by the National Institute for Automotive Service Excellence (NIASE)?
- Yes
- No
If yes, in what areas?
APPLICANT'S CERTIFICATION
I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is a ground for dismissal. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I agree to conform to the rules and regulations of the Company. I understand that if an offer of employment is extended that it is conditioned upon completing the Federal I-9 form and providing documents establishing identity and work authorization. I understand that this employment application and any other company documents are not promises of employment. I understand that my employment can be terminated with or without cause and with or without notice, at any time, at the option of either the company or myself. I understand that no manager or representative of the Company, other than the president, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.
Signature of Applicant*
Date*

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Application For Employment

I. PERSONAL DATA

II. EDUCATION

III. CHARACTER REFERENCES

IV. RECORD OF PREVIOUS EMPLOYMENT

APPLICANT'S CERTIFICATION