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? YesNo
Jobs Available Service TechnicianService Advisor/writerLube TechnicianManagement PositionOther
Position Desired Full-TimePart-TimeTemporary
Date Available
Salary Expected
Source of referral
Have you ever been convicted of a felony or a first degree misdemeanor? YesNo
If yes, please explain
Do you have a valid driver’s license? YesNo
Do you have any speeding tickets or reckless driving infractions in the last 5 years? YesNo
Have you had a DUI in the last 5 years? YesNo
If yes, when?
Will you pass a drug screening test? YesNo
Driver License Number
State Issued
Date available to start work
Emergency Contact Name
Phone Number
Emergency Contact Relationship
1) Company Name
Employed From
Employed To
Address
Final Salary
Name & Title of Immediate Supervisor
Can we contact this employer? YesNo
Your Title
Reason For Leaving
Description of Responsibilities
2) Company Name
3) Company Name
Can we contact this employer YesNo
School Name, City and State
Course of Study / Major
Years Attended
Graduated? YesNo
Title of Degree Received
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 YesNo
Words Per Minute
List ASE Certificates acquired or Awards received
1) Name
Phone
Years Known
Relationship To Applicant
2) Name
3) Name
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. *
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).
