Repair Shop Technician Application

PERSONAL INFORMATION

Name *

First

Last *

Last

Email *

Home Phone

Mobile Phone

Address *

Address

City

State/Province

Zip/Postal

Are you legally authorized to work in the United States *

Yes

No

May We Contact Present Employer *

Yes

No

Did Someone Refer You to our Company? *

Yes

No

List Name of Person Who Referred You:

Do You Have Friends or Relatives Who Work Here? *

Yes

No

List Name(s) of Friends or Relatives Working Here:

Have You Ever Been Convicted of a Felony or Misdemeanor? *

Yes

No

THE EXISTANCE OF A CRIMINAL RECORDS DOES NOT CONSTITUTE AN AUTOMATIC DISREGARD FOR EMPLOYMENT UNLESS RELAVENT TO THE TYPE OF EMPLOYMENT.

List Convictions Here:

If Offered Employment, When Are You Able to Start Working? *

EMPLOYMENT HISTORY

(Begin with most recent)

Date From

Date To

Company Name

City, State

Titles and Duties

Reason for Leaving

Supervisor Name

Contact Number

Date From

Date To

Company Name

City, State

Titles and Duties

Reason for Leaving

Supervisor Name

Contact Number

Date From

Date To

Company Name

City, State

Titles and Duties

Reason for Leaving

Supervisor Name

Contact Number

EDUCATION/TRAINING

Have you obtained a high school diploma or GED certificate? *

Yes

No

College/University (please list Name & Location, Diploma/Degree and Type of Specialization)

Specialized Courses/Training (please list Name & Location, Diploma/Degree and Type of Specialization)

Other Special Skills (skills you offer for this job opening)

REFERENCES (Give Names of 3 people not related to you)

Reference 1 Name *

Reference 1 Email *

Reference 1 Phone

Reference 2 Name *

Reference 2 Email *

Reference 2 Phone

Reference 3 Name *

Reference 3 Email *

Reference 3 Phone

Security

The information on this application is true and accurate to the best of my knowledge:

By entering your name, you are giving us your valid digital signature.

Date *

Attach Resume

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