MECHANIC/WASH TECH

Shop Application for Employment

Applicants are considered without regard to race, creed, color, sex, religion, age, national origin, or disability.

For any date fields, respond with a month/day/year format unless otherwise specified. (EX: 1/1/2000)

Position Applying For
Full Name:
Social Security Number:
 Date of Birth:
Address:
Phone: ( )
Emergency Contact (First Name):
Emergency Phone: ( )

Personal Description

Experience And Qualifications

VALID Driver's License Number
Driver's License State
Expires on
License Type (CDL, Class A, etc.)
List CDL Endorsments

Education

Grade School:
College:
Other Training
Currently Employed?
When will you be available?
What hours are you able to work?



Comments
Are you prevented from lawful employment in this county because of immigration status?
Explain

Employment History

Have you worked for this company before?
When?
Position
Reason for leaving

Most Recent Employer:

Name
Phone
()
Address
 From
 To
Wage
Position
Reason for leaving

2nd Most Recent Employer:

Name
Phone
()
Address
 From
 To
Wage
Position
Reason for leaving

3rd Most Recent Employer:

Name
Phone
()
Address
 From
 To
Wage
Position
Reason for leaving

Notice to Applicant

APPLICANT- If employer has not explained or given a job description make sure one is given to you and that you fully understand what is expected of you prior to answering the following two questions.

Can you perform the functions described in the job description?
Please explain how, with or without reasonable accommodation, you will be able to perform those functions

MUST BE READ AND SIGNED BY APPLICANT

I AGREE AND UNDERSTAND THAT ANY MISREPRESENTATIONS OF INFORMATION GIVEN ABOVE SHALL BE CONSIDERED AN ACT OF FALSIFICATION. I AGREE AND UNDERSTAND THAT THE EMPLOYER OR HIS AGENTS MAY INVESTIGATE MY BACKGROUND TO ASCERTAIN ANY AND ALL INFORMATION OF CONCERN TO MY EMPLOYMENT IS FACTUAL.

I AGREE AND UNDERSTAND THAT IF HIRED, I WILL BE ON A PROBATIONARY PERIOD DURING WHICH TIME I MAY BE DISCHARGED WITHOUT RECOURSE. THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Name:
 Date:

PREVIOUS EMPLOYER INFORMATION REQUEST

You are authorized to give/release to Dave Evans Transports, Inc. all information regarding my services, character, conduct, accidents, workman compensation, drug & alcohol testing and results while I was in your employ. You are released from all liability by furnishing the requested information.

Name:
Date:
Former Employer: