Job Application Form

PERSONAL INFORMATION

First Name

Middle Name

Last Name

Address

Street Address

City

State

Zip Code

Phone:

Social Security Number (SSN)

Date Available:

Desired Pay ($): (please indicate if it's PER HOUR or PER SALARY)

Position Applied For

Crew Manager

Flexible

Employment Desired:

Full-Time

Part-Time

Seasonal

EMPLOYMENT ELIGIBILITY

Are you legally eligible to work in the U.S.?

Yes

Have you ever worked for this employer?

Yes

If "YES", write the Start and End Dates:

Have you ever been convicted of a Felony?

Yes

If "YES", please explain:

EDUCATION

High School:

City / State:

From:

To:

Graduate?

Yes

Diploma:

College:

City / State:

From:

To:

Graduate?

Yes

Degree:

Other:

City / State:

From:

To:

Degree / Certification:

Other:

City / State:

From:

To:

Degree / Certification:

PREVIOUS EMPLOYMENT

EMPLOYER 1:

Email:

Phone:

Address

Street Address

City

State

Zip Code

Starting Pay ($):

Ending Pay ($):

Job Title:

Responsibilities:

From

Reason for Leaving:

EMPLOYER 2:

Email:

Phone

Address

Street Address

City

State

Zip Code

Starting Pay ($):

Ending Pay ($):

Job Title:

Responsibilities:

From:

To:

Reason for Leaving:

EMPLOYER 3:

E-mail:

Phone:

Address

Street Address

City

State

Zip Code

Starting Pay ($)

Ending Pay ($)

Job Title:

Responsibilities:

From:

To:

Reason for Leaving:

REFERENCES

(PROFESSIONALS ONLY)

REFERENCE 1

First Name

Last Name

Relationship:

Company:

Title:

E-mail

Phone:

REFERENCE 2

First Name

Last Name

Relationship:

Company:

Title:

E-mail

Phone:

REFERENCE 3

First Name

Last Name

Relationship:

Company:

Title:

E-mail

Phone:

MILITARY SERVICE

Are you a Veteran?

Yes

Branch:

Rank at Discharge:

From:

To:

Type of Discharge:

If not honorable, please explain:

BACKGROUND CHECK CONSENT

IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK?

Yes

DISCLAIMER

Applicant understands that this is an Equal Opportunity Employer and committed to excellence through diversity. In order to ensure this application is applicable, please type with the application being fully completed in order to be considered.

I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.

SIGNATURE:

PRINT NAME:

Date

Join our team at Citrus Valley Car Wash!

PERSONAL INFORMATION

EMPLOYMENT ELIGIBILITY

EDUCATION

PREVIOUS EMPLOYMENT

REFERENCES

MILITARY SERVICE

BACKGROUND CHECK CONSENT

DISCLAIMER

Join our team at
Citrus Valley Car Wash!