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Application for Employment
Position Applied For (list only one)
Name
Phone Alt Phone
Present Address
City, State, Zip ,
How long have you lived there? Years Months E-Mail

Desired salary/hourly rate $
If under the age of 18, can you produce the necessary work certificate at the time of employment? Yes No
Type of employment desired? Full-time Part-time If part-time specify hours/week
Are you willing to work overtime? Yes No Date on which you can start work if hired
Have you previously applied for employment with this company? Yes No
If yes, when and where did you apply?
Have you ever been employed by this company? Yes No
If yes, provide dates of employment, location, and reason for separation from employment
If applicable, list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc.

Education School name and location (address, city, state) Course of study Graduate (Y/N)? # years completed Degree/major
High school   Y N  
College Y N
Bus/Tech/Trade or post-college Y N
Honors received

Work Experience

Please list the names of your present and/or previous employers in chronological order, with present or most recent employer listed first. Provide information for the 5 most recent employers. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you from consideration for employment. Do not answer "see resume".

Employer #1
Name Address Type of business
Telephone Dates employed
From To
Job title Duties
Supervisor's Name May we contact? If not, why not?
Y N
Wages Reason for leaving
Start End
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain
Employer #2
Name Address Type of business
Telephone Dates employed
From To
Job title Duties
Supervisor's Name May we contact? If not, why not?
Y N
Wages Reason for leaving
Start End
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain
Employer #3
Name Address Type of business
Telephone Dates employed
From To
Job title Duties
Supervisor's Name May we contact? If not, why not?
Y N
Wages Reason for leaving
Start End
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain
Employer #4
Name Address Type of business
Telephone Dates employed
From To
Job title Duties
Supervisor's Name May we contact? If not, why not?
Y N
Wages Reason for leaving
Start End
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain
Employer #5
Name Address Type of business
Telephone Dates employed
From To
Job title Duties
Supervisor's Name May we contact? If not, why not?
Y N
Wages Reason for leaving
Start End
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain
Have you ever been terminated or asked to resign from any job? Y N If yes, how many times?
Has your employment ever been terminated by mutual agreement? Y N If yes, how many times?
Have you ever been given the choice to resign rather than be terminated? Y N If yes, how many times?
If you answered Yes to any of the above 3 questions, please explain the circumstances of each occasion.

References

Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school of volunter-related references.

Name Position Company Work relationship Telephone

Please list the names of personal references (not previous employers or relatives) who know you well that we may contact.

Name Occupation Address Telephone # Years known

Additional information: Please indicate where you have actual experience in any of the following positions:
Office
Office Manager
Bookkeeper
Accounts Receivable
Accounts Payable
Payroll Clerk
Tag/Title Clerk
Warranty Clerk
Data Entry
Cashier
Receptionist
Other
Sales & Leasing
Sales Manager
Sales (New Car)
Sales (Used Car)
Sales (Truck)
F & I Manager
Leasing Manager
Fleet Manager
Truck Manager
Used Car Manager
Rentals
Other
Service & Repair
Service Manager
Service Writer/Advisor
Dispatcher
Shop Foreman
Mechanic/Technician
Electrician
Helper
Painter
Body Repair
Make Ready
Other
Parts
Parts Manager
Parts Counter
Parts Stocker
Parts Driver
Other
Other
Machinist
Porter/Janitor
Security
Driver/Messenger
Maintenance
Applicant Certification
Applicant Signature Date

If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's parent or legal guardian.

Parent/Legal Guardian Date
Witness Date
Applicant Signature Date

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