Application For Employment
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1
2APPLICATION FOR EMPLOYMENT
Please complete the company application in full. Resumes
May be attached but NOT as a substitute. Only applications
That are complete, legible and signed will be considered.
APPLICANTS WILL BE TESTED FOR ILLEGAL DRUGS.
PERSONAL DATA
Date: __________
Position Applying for: ______________________________
Wage Desired__________
Name______________________________________________________________________________________________________
LAST
FIRST
MIDDLE
MAIDEN
Present address______________________________________________________________________________________________
NUMBER
STREET
CITY
STATE
ZIP
Home Phone (
)__________
Cell or Msg Phone (
)__________
Email address____________________________________
Are you a United States Citizen or an Alien legally entitled to work in the U.S.?
Yes
No
If hired, can you submit proof of age?
Yes
No
Have you ever been employed by NAPA Auto Parts?
Yes
No
If yes, give dates and position(s) held______________________________________________________________________________
(Answer only if the position you are applying for requires driving)
Licensed to drive a car?
Yes
No
Is license valid in this state?
Yes
No
Type (Circle): D-1
CDL-A
CDL-B
Driver’s License Number________________________
State of Issue__________
Exp. Date____________________
Do you have reliable transportation to work?
Yes
No
Have you ever been convicted for a DUI in any state? _____________ Have you ever had your license suspended? ______________
Have you had any accidents during the past three years?
Yes
No
How many? _________________________________
Have you had any moving violations during the past three years?
Yes
No
How many? _________________________________
Branch of
Date
Date of
Highest
Service-Related Skills and Experiences
Service
Entered
Discharge
Rank Held
Applicable to Civilian Employment
School Attended
No. of
Name of School
City/State
Graduate?
Course of Study or
Average
Years
Major
Grades
Sr. High
Tech
College
Degree:
Other
I am interested in:
Store_______
Distribution Center______
Delivery Truck Driver_______
CDL Truck Driver_______
Office_______
Sales_______
Or the following specific job___________________________________
I am seeking:
I am available for:
Temporary
Full-time
Employment
Employment
Regular
Part-time
If temporary,
If part-time, indicate maximum hours per week____________________
indicate dates available____________________
Are there any hours or days during the week when you would not be
available to work?
Yes
No
If yes, explain: _____________________________________________
How soon are you available for work? ___________
HAVE YOU EVER BEEN CONVICTED OF, PLED GUIL
TY OR NO CONTEST (NOLO CONTENDRE) TO A FELONY DURING THE
PAST 7 YEARS?
Yes
No If yes, please explain (An affirmative answer will not necessarily disqualify you from employment)
_______
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Parent category: Business