Personal Information

Name :
  • Present Address :
  • Phone #s :

Employment Desired

    Position applying for :

  • $ annually
  • Are you employed now? YesNo
  • If "Yes", where?         and may we contact your present employer? YesNo

Education

  Name & location of school Select last year completed Did you graduate? Subjects Studied and
Degree(s) Received
High School

1234 YesNo

Trade or
Business School

1234 YesNo

College

1234 YesNo

Other

1234 YesNo


  • Employment References

    Please list below three employment references with phone numbers.

    Name
    Current City & State

    Phone Number

    Position

    Years Acquainted

    Employment History

    (list most recent first)

    Dates (Month/Yr)

    Name, City & State of Employer

    Salary (upon leaving)

    Supervisor's Name

    Your Position

    Reason for Leaving

    From:

       
    To:

    $
    From:

       
    To:

    $
    From:

       
    To:

    $
    From:

       
    To:

     

    $
    From:

       
    To:

     

    $
    From:

       
    To:

     

    $

    If you are hired by Import Specialty Auto, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.

    Authorization

    I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

    I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been hired, without regard to when the matter is discovered by the Company.

    I understand and agree that nothing contained in this application or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with our without cause and without prior notice, at the option of either the Company or myself. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing.

    If I am offered employment I agree to submit to a medical examination and drug test before starting work (at the discretion of the Company). I also agree to submit to a medical examination or drug test at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug tests, and if I am hired a condition of my employment will be that I abide by the Company’s Drug and Alcohol Policy.

    I understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.

  • *** PLEASE PRINT A COPY OF THIS FORM BEFORE PRESSING "SEND" ***