Fields marked (*) are required

Personal Data

Name:*

Date:*

Position Applying For:*

Email:*

Social Security Number:*

Address:*

City:*

State:*

Zip:*

Home Phone:*

Cell Phone:

Do you have a valid driver's license?:*
Yes No License Number:*

Exp. Date:*

Do you have adequate transportation to and from work?*
Yes No
Is there anything that would prevent you from getting to work on time?*
Yes No
Is there anything that would prevent you from having flexible hours?*
Yes No
Have you been cited for a traffic violation of any kind within the last five years?*
Yes No
If yes, pleas give data and details:


Who were you referred by?


Pay request:


Education

Elementary
School Name:

Years Completed:

Diplomas/Degrees:

Study/Major:


High School
School Name:

Years Completed:

Diplomas/Degrees:

Study/Major:


College/University
School Name:

Years Completed:

Diplomas/Degrees:

Study/Major:


Graduate/Professional
School Name:

Years Completed:

Diplomas/Degrees:

Study/Major:


Describe Specialized Training, Military Experience, Skills and Extracurricular Activities:


Record of Previous Employment
Please list the names of your previous employers in chronological order with present or las emplyer listed fisrt. Be sure to account for all periods of time including military service and any period of unemployment. If you were self-employed, give the business name and supply business references. Employer

Employer 1
Company Name:

Address:

City:

State:

Zip:

Phone:

Employed from (mon./yr.) to (mon./yr.)

Starting Salary:

Ending Salary:

Your Title or Position:

Name of Last Supervisor:

Reason for Leaving:


Employer 2
Company Name:

Address:

City:

State:

Zip:

Phone:

Employed from (mon./yr.) to (mon./yr.)

Starting Salary:

Ending Salary:

Your Title or Position:

Name of Last Supervisor:

Reason for Leaving:


Employer 3
Company Name:

Address:

City:

State:

Zip:

Phone:

Employed from (mon./yr.) to (mon./yr.)

Starting Salary:

Ending Salary:

Your Title or Position:

Name of Last Supervisor:

Reason for Leaving:


Employer 4
Company Name:

Address:

City:

State:

Zip:

Phone:

Employed from (mon./yr.) to (mon./yr.)

Starting Salary:

Ending Salary:

Your Title or Position:

Name of Last Supervisor:

Reason for Leaving:


With what employer/company did you enjoy working with/for the most?
Why?


References
List professional references who are familiar with the quality of your work, have worked directly with you, and have know you for at least two years.

Reference 1
Name:

Occupation:

Address:

Phone:

Years Known:


Reference 2
Name:

Occupation:

Address:

Phone:

Years Known:


Reference 3
Name:

Occupation:

Address:

Phone:

Years Known:


Reference 4
Name:

Occupation:

Address:

Phone:

Years Known:


Additional Information

Have you ever been terminated or asked to resign from any job?
Yes No
If yes, explain the circumstances:


Please explain any gaps in your employment history:


May we contact your most current employer? Yes No

Have you ever pled guilty or "no contest" to, or been convicted of a misdemeanor or felony? Yes No
If yes, please give details and dates of each:


Have you been arrested for any matter for which you are out on bail or on you own recognizance pending trial? Yes No

Experience
Please indicate actual work experience you have in any of the folloing areas or positions.

Administration:
Accounts Receivable
Accounts Payable
Bookkeeper
Cashier
Computer Accounting
Data Entry
Finacial Analysis
Insurance Claims
Job Costing
Office Manager
Payroll Clerk
Real Estate
Receptionist
Tax Returns
Warranty Clerk
Word Processing

Sales:
Customer Service Representative
Department Sales Manager
Leasing Manager
Phone Sales
Regional Sales Manager
Salesperson (New)
Salesperson (Used)
Salesperson Retail
Salesperson Service
Salesperson Wholesale

Production:
Frame Technician
Universal Bench System
Dedicted Jig System
Body Technician
Mig Welding
Oxy/Acetylene Wlding
Mechanic
Suspension and Steering
Wheel Alignment
Plastic Repair
Cooling System
Air Conditioning
ABS Brakes
Air Bag System
Exhast System
Automotive Electrical
Apprentice/Helper
Color Matching
Computerized Paint Mixing
Paint Preparation
Refinish Technician
Machine Polishing
Detailer
Maintenance
Glass Installation

Other:
Shop Manager
Service Manager
Service Writer/Advisor
Estimator
Insurance Adjuster
Insurance Appraiser
Shop Foreman
Production Manager
Department Manager
Parts Manager
Parts Counter Person
Inventory Control
Purchasing Agent
Advertising/Marketing

Questionnaire

Remarks and Special Qualifications:


Computer skills and system/program knowledge:
(Please be specific.)


Computer Skill Level:
Journeyman Apprentice Trainee

What do you know about this industry?


What do you not know or understand about this industry?


What questions do you have about this job and/or working for us?


How long will you be staying with the company?


What would you say are the traits of a good employee would posses?


What were you biggest perssures at you last job?


What was you resource when you had a great deal of work to accomplish in a short time?


What kinds of people annoy you the most?


What steps have you ever taken to resolve a coworker disagreement?


In what way do you like to take direction?


Do you find that people look to you when a project is stalled or when no one seems willing to take on a delegated task?


You are to type a letter that needs to go out by the ned of the bsiness day, it is 4:30 pm and you still have not received the dictation from the manager, another manager comes to your des and asks if the letter is complete, what do you do?


Would you rather have a lot of control over how you do your job or would you prefer to have expectations clearly spelled out by your superiors?


What criteria do you use to define success?


Often people say they support a standard or idea even if they don't really live up to the level they claim. If you could strenghten one or two of these standards, which would they be?


There are times when customer don't need to know everything, can you tell me about a time when you didn't tell the whole story?