Application For Employment - Jiffy Lube printable pdf download

APPLICATION FOR EMPLOYMENT

It is the policy of this company to provide equal employment opportunities to all qualified persons without

regard to race, creed, color, religious belief, sex, age, national origin, physical or mental handicap or

veteran status. PLEASE PRINT.

PERSONAL DATA

POSITION(S) APPLYING FOR: ________________________________________

Date ________________

Name: _______________________________________________________________________________________

First

Middle

Last

Address: ____________________________________________________________________________________

Street and Apt. #

City

State

Zip Code

Phone Number: ________________________________

_________________________________

Daytime

Evening

Social Security #: __________________

Driver’s License #: ________________State: ____Expires ___________

How did you hear about this position? ________________________________________________________________

Can you prove you are a U.S. Citizen or otherwise authorized to

Salary Desired? _____________________

work in the United States on an unrestricted basis: Yes ______ No ______

If applicable, please list your visa type, visa # and expiration: ____________________________________

If under 18 years of age, can you furnish a work permit if required? __________ If, not please explain

If hired, are you able to get to work and meet attendance requirements every day? ___________________

Have you been convicted of a felony in the last five years? _______ If so, please explain.

(Conviction does not automatically bar you from employment consideration.)

Type of employment wanted:

Full Time_____ Part Time ____ Temporary ____

Date available for work: ____ What hours do you prefer to work? _________________________________

Can you work overtime, if required? _____ Weekends if required? _____ Please list hours you cannot

work ________________________ Will you relocate if the job requires it? ______

Will you travel if required? _____ How many days of work or school have you missed in the last year for

reasons other than sickness? _____ Please explain:

EDUCATION BACKGROUND Please circle the highest level of education attained.

Elementary Junior High High School G.E.D Technical/Trade School (which field?)

_____________________________________ Military Education ____________________________

College 1 2 3 4 College Name and City _____________________ Graduate School ______________

Are you currently in school? __ What level? ___ Summarize special training or skills that may qualify you

___________________________________________________________________________________

Application For Employment - Jiffy Lube