employment

Personal Information

Name*

Desired Salary*

Available Start Date*

*Note: A valid Social Security number and Driver's License must be provided upon being offered a position at Femal's Auto Body.

Are you a citizen of the United States?*

YesNo

If no, are you authorized to work in the United States?*

YesNo

Have you previously been employed with Femal's Auto Body?*

YesNo

If yes, when?

Have you ever been convicted of a felony?*

YesNo

If yes, what?

Education History

High School

Did You Graduate?*

YesNo

College

Trade, Business or Correspondence School

Did You Graduate?

YesNo

References

Please list three (3) employment or personal references. Do not list relatives.

Reference 1*

Reference 2*

Reference 3*

Employment History

Employer*

Address*

Phone Number*

Supervisor*

Job Title*

Type of Position*

Full-timePart-timeSeasonalTemporary

Time Employed*

Hourly Rate or Salary*

May we contact this employer for reference?*

YesNo

Employment History Continued

Employer

Address

Phone Number

Supervisor

Job Title

Type of Position

Full-timePart-timeSeasonalTemporary

Time Employed

Hourly Rate or Salary

May we contact this employer for reference?

YesNo

Military Service

From what time?

If other than honorable, explain:

Certification

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my pervious employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company 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, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability related or medical information in a manner prohibited by the Americans of Disabilities Act (ADA) and other relevant federal and state laws.”

I understand and agree to the above disclosure statement

* By typing my name, I am electronically signing my application.