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(928) 526-5526
622 E Rte 66, Flagstaff, AZ 86001
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Employment App.
Employment Application
How long have you lived here?
Employment Interest
Desired salary / hourly rate?
If under the age of 18, can you provide the required work permit at time of employment?
Yes
No
Type of employment desired?
Full-Time
Part-Time
If part-time how many hours a week?
Are you willing to work overtime?
Yes
No
Start Date
Have you previously applied for employment with this company?
Yes
No
if yes, when and where did you apply?
Have you ever been employed by this company?
Yes
No
If yes, provide dates of employment, location, and reason for separation from the company
If applicable, list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc.
Education
Education
School name, address, state, city and zipcode
Course of study
Graduated (Y/N)?
# Years Completed
Degree / Major
High School
Yes
No
College
Yes
No
Business / Tech / Trade or other Post-College
Yes
No
Work Experience
Please list the names of your present and/or previous employers in chronological order, with present or most recent employer listed first. Provide information for the 5 most recent employers. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you from consideration for employment. Do not answer "see resume".
Employer #1
Name
Type of business
Address
Email
Dates Employed
Job Title
Duties
Supervisor's Namee
May We Contact?
Yes
No
If not, why not?
Wages
Reason for leaving
What will this employer say was the reason your employment was terminated?
How much notice did you give when you resigned?
If none, explain
Employer #2
Name
Type of business
Address
Email
Dates Employed
Job Title
Duties
Supervisor's Namee
May We Contact?
Yes
No
If not, why not?
Wages
Reason for leaving
What will this employer say was the reason your employment was terminated?
How much notice did you give when you resigned?
If none, explain
Employer #3
Name
Type of business
Address
Email
Dates Employed
Job Title
Duties
Supervisor's Namee
May We Contact?
Yes
No
If not, why not?
Wages
Reason for leaving
What will this employer say was the reason your employment was terminated?
How much notice did you give when you resigned?
If none, explain
Employer #4
Name
Type of business
Address
Email
Dates Employed
Job Title
Duties
Supervisor's Namee
May We Contact?
Yes
No
If not, why not?
Wages
Reason for leaving
What will this employer say was the reason your employment was terminated?
How much notice did you give when you resigned?
If none, explain
Employer #5
Name
Type of business
Address
Email
Dates Employed
Job Title
Duties
Supervisor's Namee
May We Contact?
Yes
No
If not, why not?
Wages
Reason for leaving
What will this employer say was the reason your employment was terminated?
How much notice did you give when you resigned?
If none, explain
Have you ever been terminated or asked to resign from a job?
Yes
No
If so how many times?
Has your employment ever been terminated by mutual agreement?
Yes
No
If so how many times?
Have you ever been given the choice to resign rather than be terminated?
Yes
No
If so how many times?
If you answered Yes to any of the above 3 questions, please explain the circumstances of each occasion.
References
Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school of volunteer-related references.
Name
Position
Company
Work Relationship
Telephone
Name
Position
Company
Work Relationship
Phone
Name
Position
Company
Work Relationship
Phone
Name
Position
Company
Work Relationship
Phone
Please list the names of personal references (not previous employers or relatives) who know you well that we may contact.
Name
Occupation
Address
Telephone
# Years known
Name
Occupation
Address
Phone
# Years known
Name
Occupation
Address
Phone
# Years known
Name
Occupation
Address
Phone
# Years known
Additional information: Please indicate where you have actual experience in any of the following positions:
Office
Office Manager
Bookkeeper
Accounts Receivable
Accounts Payable
Payroll Clerk
Tag/Title Clerk
Warranty Clerk
Data Entry
Cashier
Receptionist
Other
Sales & Leasing
Sales Manager
Sales (New Car)
Sales (Used Car)
Sales (Truck)
F & I Manager
Leasing Manager
Fleet Manager
Truck Manager
Used Car Manager
Rentals
Other
Service & Repair
Service Manager
Service Writer/Advisor
Dispatcher
Shop Foreman
Mechanic/Technician
Electrician
Helper
Painter
Body Repair
Make Ready
Other
Parts
Parts Manager
Parts Counter
Parts Stocker
Parts Driver
Other
Other
Machinist
Porter/Janitor
Security
Driver/Messenger
Maintenance
Applicant Signature
Date
If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's parent or legal guardian.
Parent/Legal Guardian
Date
Witness Signature
Date
Verification
Submit
