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PLEASE NOTE
1. This application will be current for 90
days from this date. After that it
must be renewed to be considered.
2. You must fill in your own application.
3. All questions must be answered for this
application to be considered. If not
applicable, please indicate. |
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*Name: |
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Present
Address: |
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Previous Address:
(If less than one year at present address) |
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Email Address: |
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Phone Number: |
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Are you under the age of 18 ?
(if yes, proof will be required.) |
Yes
No |
Have you ever been convicted of a
crime other than a minor traffic violation ?
(Conviction of a crime will not result in automatic
disqualification.) |
Yes
No |
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If yes, where and when? |
City/State:
Date: |
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Position applying for: |
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How did you learn of this position
? |
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Do you desire: |
Full Time
Part Time |
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Date available to start work: |
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Days available: |
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Hours available: |
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Are there any days, hours of shift
you cannot work ? |
Yes
No |
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If yes, list:: |
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Have you ever been employed by
East Coast Auto Source ? |
Yes
No |
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If yes, where and when ? |
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Do you have any relatives who are
currently employed by East Coast Auto Source ? |
Yes
No |
List any professional or trade
groups and any other organizations which you
consider
relevant to your ability to perform the position for
which you are applying.
(Do not list any organization which may reveal your
race, Sex, color, age, handicap, marital status, or
ancestry.) |
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EDUCATION |
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List any
schooling or course work that would be relevant
to the position for which you are applying. |
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Name of School: |
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Address: |
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Work Related Course: |
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Name of School: |
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Address: |
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Work Related Course: |
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Name of School: |
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Address: |
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Work Related Course: |
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MILITARY |
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Where you in the military ? |
Yes
No |
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If yes, what branch ? |
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Length of service: |
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Explain any military experience
that may relate to the position for which you are
applying: |
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REFERENCES
(not including relatives) |
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Name and Title: |
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Address: |
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Phone: |
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Name and Title: |
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Address: |
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Phone: |
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Name and Title: |
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Address: |
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Phone: |
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EMPLOYMENT HISTORY |
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Please list your
last three employers, beginning with your current
employer.
If you are not employed, list your last job first. |
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Name and Address: |
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Type of Business: |
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Job Title: |
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Supervisor's Name: |
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Duties and Responsibilities: |
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Reason for leaving or wishing to
leave: |
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DATE OF
EMPLOYMENT |
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From: |
Month
Year
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Beginning Wage: |
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Ending Wage: |
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Telephone Number: |
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Name and Address: |
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Type of Business: |
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Job Title: |
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Supervisor's Name: |
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Duties and Responsibilities: |
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Reason for leaving or wishing to
leave: |
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DATE OF
EMPLOYMENT |
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From: |
Month
Year
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Beginning Wage: |
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Ending Wage: |
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Telephone Number: |
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Name and Address: |
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Type of Business: |
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Job Title: |
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Supervisor's Name: |
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Duties and Responsibilities: |
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Reason for leaving or wishing to
leave: |
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DATE OF
EMPLOYMENT |
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From: |
Month
Year
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Beginning Wage: |
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Ending Wage: |
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Telephone Number: |
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Have you ever been terminated or
asked to resign from a position ? |
Yes
No |
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May we contact your current
employer ? |
Yes
No |
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SUMMARY
List any specialized skill or information you feel
is pertinent to the position for which you are
applying. |
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In case of
emergency, notify |
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Name and Title: |
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Phone: |
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Address: |
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I hereby agree and understand that as a condition of
employment or continued employment, I may be
required to submit to a physical examination, urine
testing, or other tests or examinations upon request
of the company if such is not prohibited by
applicable law.
If employed by East Coast Auto Source, I understand
that the employment is for no definite period of
time and may be terminated at will by me or by East
Coast Auto Source with or without cause or notice at
any time. I further understand that no
representative of the company has the authority to
enter into any employment agreement contrary to the
foregoing.
I certify that my application for employment is true
and complete and I understand that if employed,
false or omitted statements on this application or
any other company documents shall be considered
sufficient cause for immediate dismissal. You are
hereby authorized to make any investigation of
court, police, character, and my previous employment
records. |
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