Demo Company 123 Application Step 1 of 4 25% Company Name*Select the business location that is considering you for employment.Demo Company 123APPLICATION FOR EMPLOYMENT WE ARE AN EQUAL OPPORTUNITY EMPLOYERAPPLICANT’S STATEMENT: I understand that the Dealership is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, handicap or disability, genetic information, citizenship status, service member status, pregnancy, childbirth, or related medical condition, or any other category protected by Federal, State, or Local Law. I authorize former and present employers, and professional, work, and personal references listed in the application or interview process and any other individuals I may name, to give the Dealership or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to the Dealership. I also authorize the Dealership to provide truthful information concerning my employment (if any) with it to future employers or as may be required, and I agree to hold it harmless for providing such information. I understand that the Dealership reserves the right, to the extent permitted by applicable law, to require drug and alcohol screening tests of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to the Dealership or its designees. I release the Dealership and its designees from any and all liability and damages that may result or arise from any drug test or the provision of information in connection with such a test. Testing, if any, will only occur in accordance with applicable legal requirements. I understand that this employment application and any other Dealership documents are not promises of employment. Should I be employed, I understand that my entire employment will be on a an at-will basis. I understand that I can terminate my employment at any time with or without cause and with or without advance notice and that the Dealership has a similar right. I understand that no manager, representative, or agent of the Dealership has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except that the President may do so in writing. In the event of my employment, with this Dealership, I will comply with all rules and regulations of the Dealership. I certify that the information given by me on this application and during the interview process is and will be true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the Dealership’s judgment) that I will be disqualified from consideration for employment or subject to immediate termination if discovered after I am hired. I certify that I have received a separate written notification that the Dealership may obtain “consumer reports” (for example, criminal history, driving records, etc.) on me for use in connection with my application and, if I am hired, my employment. I authorize the Dealership to obtain such reports unless otherwise prohibited by Federal, State or Local Law. This application will be considered “active” for a maximum of thirty (30) days. If you wish to be considered for employment after that time, you must reapply. DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THESE STATEMENTS.Date MM slash DD slash YYYY Signature Each inquiry on this application must be fully answered or completed. Otherwise, you will not be considered for employment. Position Desired (only list one choice) Minimum Acceptable Pay Rate Placement DesiredFull-timePart-timeTemporaryWhen are you available for work? Personal DataName First Middle Last Email Present Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you lived there? Previous Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long did you live there? Telephone Number(s) (Home, Cell, Other)Are you 18 years of age or older? Yes No Current and Previous EmploymentPlease list the names of your present and previous employers in chronological order with present or last employer listed first. Include part-time, seasonal and all other employment. If self-employed, give company name and supply business references. If you need more space, use a separate sheet of paper. DO NOT ANSWER “SEE RESUME.” Fill out this form completely. Employer 1 Phone - (xxx) xxx-xxxxAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employed From Date MM slash DD slash YYYY Employed To Date MM slash DD slash YYYY Starting Rate/Salary Final Rate/Salary Job Title Supervisor Name & Title Work PerformedWere you ever disciplined? If so, for what?Reason for Leaving Employer 2 Phone - (xxx) xxx-xxxxAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Name & Title Employed From Date MM slash DD slash YYYY Employed To Date MM slash DD slash YYYY Starting Rate/SalaryFinal Rate/SalaryWork PerformedWere you ever disciplined? If so, for what?Reason for Leaving Employer 3 Phone - (xxx) xxx-xxxxAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Name & Title Employed From Date MM slash DD slash YYYY Employed to date MM slash DD slash YYYY Starting Rate/Salary Final Rate/Salary Work PerformedWere you ever disciplined? If so, for what?Reason for Leaving Employer 4 Phone - (xxx) xxx-xxxxAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Name & Title Employed From Date MM slash DD slash YYYY Employed To Date MM slash DD slash YYYY Starting Rate/Salary Final Rate/Salary Work PerformedWere you ever disciplined? If so, for what?Reason for Leaving Background InformationAre you currently working? Yes No If 'yes', name of your employer: Please explain fully any gaps in your employment history. Be sure to account for all periods of time including any period of unemployment.List any other names (name change, assumed name, nickname, etc.) which you may have used, and which will be necessary to verify prior to your employment or education record:If hired, can you provide proof that you are legally entitled to work in the U.S.? Yes No If not, what steps must be taken for you to begin employment lawfully?Have you ever been terminated or asked to resign from any job? Yes No If yes, please explain circumstancesMay we contact your current employer? Yes No If no, please explain:Have you ever worked for any of the other Dealerships? Yes No If yes, please give dates, position and location:Do you have any friends or relatives working for a Dealership? Yes No If yes, name(s), relationship and location:How were you referred to us? Do you have any commitments to any other employer which could affect your employment with us if hired (for example, an employment agreement, a non-competition or non-solicitation agreement, etc.? Yes No If yes, explain: EducationHigh SchoolName & Location (City, State) Grade Completed 9 10 11 12 Describe Course of Study or MajorDescribe Specialized Experience, Training, Skills, and Extra-Curricular Activities College / UniversityName & Location (City/State) Year Completed 1 2 3 4 Describe Course of Study or MajorDescribe Specialized Experience, Training, Skills, and Extra-Curricular Activities Graduate / Professional SchoolName & Location (City, State) Years Completed 1 2 3 4 Describe Course of Study or MajorDescribe Specialized Experience, Training, Skills, and Extra-Curricular Activities Trade or Correspondence SchoolName & Location (City, State) Describe Course of Study or MajorDescribe Specialized Experience, Training, Skills, and Extra-Curricular ActivitiesOther InformationList any professional or occupational registration, licensure or certification you currently hold which may be applicable:Please provide any other information or comments, or describe any other experience that you have which would be relevant to the job for which you are applying:Please describe both your immediate and long-term career goals: Relevant ExperiencePlease indicate positions you have held in prior jobs (hold down the control or command key to select more than one):OfficeControllerOffice ManagerBookkeeperAccounts ReceivableAccounts PayablePayroll ClerkTag/Title ClerkWarranty ClerkData EntryCashierSales/LeasingSales Manager (New)Sales Manager (Used)Sales Person (New)Sales Person (Used)Leasing ManagerFleet ManagerAfter Market SalesDeliveryServiceService ManagerService Writer/AdvisorDispatcherShop ForemanMechanic/TechnicianHelperPainterGet Ready/PrepBody RepairEstimatorAdjusterPartsParts ManagerParts CounterpersonParts StockerParts DriverFinanceF & I ManagerF & I SalesCriminal HistoryApplicants must not include any information about arrests or convictions that were sealed, eradicated, erased, annulled or expunged, or convictions that resulted in referral to a diversion program when responding to these two questions.Have you ever plead no contest, nolo contendere, or guilty to a misdemeanor crime, or been convicted of a misdemeanor crime? Yes No Have you ever plead no contest, nolo contendere, or guilty to a felony crime, or been convicted of a felony crime? Yes No NOTE: Answering “yes” to either of these questions does not constitute an automatic bar to employment. The Dealership will consider the nature of the crime, its seriousness, the substantial relation to the position’s functions and qualifications, the number of occurrences, the applicant’s age at the time of the crime, the time elapsed since the crime, the applicant’s entire work and educational history, employment references and recommendations, and the business necessity of any exclusion when required by law.If you answered yes to either of the two preceding questions, please give dates and details for each incident:(Complete only if driving is an essential function of the job for which you are applying. If so, any employment is contingent on an acceptable driving record that meets the standards of the Dealership and it’s insurance company. If hired, your driving record will be checked periodically.) Do you have a current valid driver’s license? Yes No If yes, please put your License No., State and Expiration Date: If you do not have a driver’s license for the state in which you currently reside, why not? Has your license ever been suspended or revoked? Yes No If yes, explain Do you have personal automobile insurance? Yes No If no, explain: Have you ever been denied personal automobile insurance or has it ever been terminated or suspended? Yes No If yes, explain: Have you ever been convicted, pled guilty, or pled nolo to a charge of DWI or DUI? Yes No Are any such charges currently pending against you? Yes No If yes to either question, explain:Please list all moving traffic violations in the last five (5) years:Offense Date MM slash DD slash YYYY Location Comments Offense Date MM slash DD slash YYYY Location Comments For employment purposes, the Company may obtain consumer reports on you as an applicant or from time to time during employment. "Consumer reports" are reports from consumer reporting agencies and may include driving records, criminal records, etc. For such employment purposes, the Company may also obtain investigative consumer reports. Some reference checks by a consumer reporting agency fall into this category. An "investigative consumer report" is a consumer report in which information as to character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with neighbors, friends, associates, acquaintances, or others. You have a right to request disclosure of the nature and scope of an investigation and to request a written summary of consumer rights.NameThis field is for validation purposes and should be left unchanged. Δ
