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Application for Employment

Name *

First

Middle

Last

Address *

Contact Information *

Have you ever been convicted of a felony? *

yes
no

If yes, explain:

Are you a U.S. Citizen? *

yes
no

Are you willing to submit to a Drug Screening test? *

yes
no

This establishment requires a valid driver's license. Do you have a valid driver's license? *

yes
no

Date of Birth *

DL#: *

Past Employment at Auto Spa *

yes
no

Education *

Past Employment *

Position Sought: *

Desired Pay Rate: *

Available Start Date: *

Are You Currently Employed: *

I certify that all answers given here are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in Discharge. *

I accept
I decline

Name

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