Looking for a great career?

First Name:

Last Name:

Address:

City:

State:

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ZIP:

Telephone:

Email:

Desired Position:

- Select - Tire Technician Wheel Sales Tire Sales Counter/cashier Wheel and Tire Sales Other

If Other:

Please list chronologically, beginning with most recent experience.

Job Number 1

Employer:

Address and City:

From (MM/YYYY):

To (MM/YYYY):

Supervisor:

Phone:

Salary:

Type of Work:

Reason for Leaving:

Job Number 2

Employer:

Address and City:

From (MM/YYYY):

To (MM/YYYY):

Supervisor:

Phone:

Salary:

Type of Work:

Reason for Leaving:

Job Number 3

Employer:

Address and City:

From (MM/YYYY):

To (MM/YYYY):

Supervisor:

Phone:

Salary:

Type of Work:

Reason for Leaving:

 

High School Education

Name and Location of school:

Year Completed:

- Select - 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Other

Major Course:

Diploma/Degree:

College/University

Name and Location of School

Select Last Year Completed

- Select - 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Other

Major Course

Diploma/Degree

- Select - Bachelors Masters Doctorate Other None

College/University

Name and Location of School

Select Last Year Completed

- Select - 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Other

Major Course

Diploma/Degree

- Select - Bachelors Masters Doctorate Other None

Business or Trade School

Name and Location of School

Last Year Completed

Major Course

Diploma/Degree

Are you legally authorized to work in the U.S.? (If hired, you will be required to provide proof of work authorization.)

Yes No

Have you ever worked for this company?

Yes No

Briefly describe skills you may have that you acquired in other employment or armed forces.

Have you ever been convicted of a crime (felony)?

Yes No

If yes, give details
(Convictions are not automatic bar to employment)

Do you have any other skills you wish to mention?

Are you presently employed?

Yes No

If so, may we contact your present employer?

Yes No

If hired, when would you be available?

List individuals familiar with your job qualifications (No relatives or personal friends).

Reference Number 1

Name:

Occupation:

Address:

City:

State:

- Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP:

Phone:

Relationship:

How long known:

Gender:

Male Female

Race/Ethnic Group:

- Select - White Black/African American American Indian or Alaskan Native Asian Hispanic or Latino (All Races) Hispanic or Latino (White Race Only) Hispanic or Latino (All Other Races) Native Hawaiian or Other Pacific Islander

Reference Number 2

Name:

Occupation:

Address:

City:

State:

- Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP:

Phone:

Relationship:

How long known:

Gender:

Male Female

Race/Ethnic Group:

- Select - White Black/African American American Indian or Alaskan Native Asian Hispanic or Latino (All Races) Hispanic or Latino (White Race Only) Hispanic or Latino (All Other Races) Native Hawaiian or Other Pacific Islander

Other Reference Information

How Were You Referred To This Job:

- Select - Advertisement School/College State Job Service Employee Referral Employment Agency Temporary Agency Government Agency Walk-In Recruiter Other

All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information, I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment.

Regardless of whether or not I become employed by the company, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company's unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other that an officer or official of the company, and then only by means of a signed written document.

I have read and accept the above statement.