Employment Step 1 of 4 25% APPLICATION FOR EMPLOYMENT AUTO TRUCK CENTER, INC. An Equal Opportunity EmployerInstructions: Please print all information and complete every part of this application. If there is a question that does not apply to you mark “N/A.” Do not leave any question unanswered. Any false, misleading or incomplete responses may result in disqualification for hire or immediate dismissal from employment. You may add another page if necessary.Position(s) applied for: 1) 2) Today’s Date: Date you can start: How did you learn about this job? Name: First Middle Last Home Address: City State / Province / Region ZIP / Postal Code Phone:Social Security Number: Are you available: Full-Time Part-Time Temporary Please describe any work limitations: Have you applied for a job with us before? Yes No If yes, Date: MM slash DD slash YYYY Have you been employed by us before? Yes No If yes, state date and job(s): Do you have relatives employed by us? Yes No If yes, please list the relative(s): Are you at least 18 years old? Yes No If not, are you at least 16 years old? Yes No Have you ever been convicted of a felony, or any crime related to theft or dishonesty, or involving acts of violence? Yes No If yes, please describe: NOTE: A conviction record will not necessarily disqualify an applicant from employment. The circumstances of the conviction will be considered in relation to the nature and duties of the job applied for. Are you a citizen of the United States or specifically authorized to be employed in the United States: Yes No NOTE: The law requires that you provide evidence and a sworn statement of your citizenship or work authorization if you are hired. Any offer of employment, which you received, is contingent upon your providing the documentation that we will request from you.PRIOR EMPLOYMENT List your last three jobs, beginning with the most recent (omit dates for jobs held more than five years ago).1. Employer Name / Address / Phone:Job Title: Duties: Date MM slash DD slash YYYY ToDate MM slash DD slash YYYY Salary/Bonus: Reason for Leaving: May we contact this employer? Yes No 2. Employer Name / Address / Phone:Job Title: Duties: Date MM slash DD slash YYYY ToDate MM slash DD slash YYYY Salary/Bonus: Reason for Leaving: May we contact this employer? Yes No 3. Employer Name / Address / Phone:Job Title: Duties: Date MM slash DD slash YYYY Date MM slash DD slash YYYY Salary/Bonus: Reason for Leaving: May we contact this employer? Yes No EDUCATION AND TRAINING Name and Location of High School: Graduated: Yes No List technical or trade school, college and post-graduate education, if any: School/College Level Completed Degree Major Subjects 1. 2. 3. OTHER SKILLSDescribe any computer, office machine, tool or equipment skills and proficiency level:Describe any other special skills or qualifications that may help you in the position applied for:List all professional licenses or certifications held, including state, license, or certificate type, date issued, and license or certificate number:_List any relevant professional or business organizations to which you belong (Optional):VETERAN STATUS If you are a veteran of the armed forces of the United States, please provide the following information:Military Branch: Date of Service: Discharge Date: Honorable Discharge: Yes No NOTE: A less than honorable discharge will not automatically disqualify you from employment. REFERENCES List three personal references, other than prior employers or relatives, whom we can contact.1. Name: Phone:Length of time known: Occupation: 2. Name: Phone:Length of time known: Occupation: 3. Name: Phone:Length of time known: Occupation: APPLICANTS ARE SUBJECT TO PRE-EMPLOYMENT DRUG TEST. PLEASE INITIALAUTO TRUCK CENTERApplicant NameBy signing below, I certify that the answers and information given above are true, accurate and complete to the best of my knowledge. I acknowledge that if any answer or information is not true, accurate or complete, I may not be hired, or if hired, I may be discharged. I authorize Auto Truck Center in researching my statements contained in this application for employment and to investigate my character, qualifications, prior work and educational history, experiences and incidents. I authorize my prior employers, references, and other contact information regarding my work or educational history, experiences, incidents and character references, to provide Auto Truck Center with all requested information and references and to cooperate fully with the vetting of my character and qualifications. I understand that this application is not a contract of employment. I also acknowledge that no oral representations have been made, and that no one within Auto Truck Center has the authority to make oral contracts of employment. If hired, my employment relationship with Auto Truck Center is terminable at-will with or without cause, by either Auto Truck Center or myself. I also understand that a physician selected by Auto Truck Center, to which I herby consent, may condition my employment upon a favorable health evaluation, which may include a medical examination. I understand and agree to all of the conditions and statements set forth above and throughout this application.Applicant’s SignatureMax. file size: 100 MB.Date MM slash DD slash YYYY
