GENERAL Name (Last, First, Initial) * SSN * Current Address (Street, City, State) * Zip Code * Date * Date of Birth Phone # * Alternate Phone # * If hired, can you provide proof of citizenship or legal right to work? * Yes No Jobs Available * Service Technician Service Advisor/writer Lube Technician Management Position Other Position Desired * Full-Time Part-Time Temporary Date Available * Salary Expected * Source of referral * Have you ever been convicted of a felony or a first degree misdemeanor? * Yes No Do you have a valid driver’s license? * Yes No Do you have any speeding tickets or reckless driving infractions in the last 5 years? * Yes No Have you had a DUI in the last 5 years? * Yes No If yes, when? Will you pass a drug screening test? * Yes No Driver License Number * State Issued State available to start work * Emergency Contact Name * Phone Number * Emergency Contact Relationship * EMPLOYMENT HISTORY – Starting with the most recent 1) Company Name * Employed From * Employed To * Address * Phone Number * Final Salary * Name & Title of Immediate Supervisor * Can we contact this employer? * Yes No Your Title * Reason For Leaving * 2) Company Name Employed From Employed To Address Phone Number Final Salary Name & Title of Immediate Supervisor Can we contact this employer? Yes No Your Title Reason For Leaving 3) Company Name Employed From Employed To Address Phone Number Final Salary Name & Title of Immediate Supervisor Can we contact this employer Yes No Your Title Reason For Leaving School Name, City and State Course of Study / Major Years Attended Graduated? Yes No If yes, when? Title of Degree Received College, University or Tech School School Name, City and State Course of Study / Major Years Attended Graduated? Yes No If yes, when? Title of Degree Received School Name, City and State Course of Study / Major Years Attended Graduated? Yes No If yes, when? Title of Degree Received Additional Skills and/or Training List any skills and/or training you have that are relevant to the position you are applying for.
Yes, I speak English
Yes, I read English
Yes, I can write English Other Language
Yes, I speak this language
Yes, I read this Language
Yes, I can write this Language Typing Skills Yes No Words Per Minute List ASE Certificates acquired or Awards received PERSONAL REFERENCES – List three people not related to you 1) Name * Phone * Years Known * Relationship To Applicant * 2) Name * Phone * Years Known * Relationship To Applicant * 3) Name * Phone * Years Known * Relationship To Applicant *
I certify that my application and all attachments are true and complete to the best of my knowledge. I understand that any incorrect, incomplete, or false statements or information furnished by me may, at the discretion of Top Performance Automotive, disqualify me from employment, or cause my dismissal. I hereby authorize Top Performance Automotive to make a thorough investigation of my past employment and activities. I release from liability Top Performance Automotive, former employers, or any persons supplying such information. The language in this application is not intended to create, nor is it to be misconstrued to constitute, a contract of employment.
I have read, understood and consent to these statements. * Date
No person shall be denied employment on the basis of race, color, ethnicity, national origin, sex/gender, sexual orientation, religion, creed, disability (including HIV status, age, veteran status, marital status or ex-offender status).