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Job Application- JeepersDen & Truck Accessories
Please fill this out to the best of your ability and we will contact you for interview.
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* Indicates required question
Name
*
First, Last
Your answer
Email Address
*
Name@Company.com
Your answer
Social Security Number
*
Your answer
Date of Birth
*
Your answer
Date of Application
*
Your answer
Present Address
*
Your answer
Telephone
*
Your answer
If under 18, please list current age:
Your answer
Position applied for
*
Your answer
Pay desired
*
Please be specific.
Your answer
Days available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Required
How many hours can you work weekly?
*
Your answer
Employment desired
*
FULL-TIME only
PART-TIME only
FULL or PART-TIME
Educational History
*
Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.
Your answer
Have you ever been convicted of a crime?
*
Yes
No
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Your answer
Office Skills
*
Please check any skills you have.
PC
Mac
Retail
Customer Service
Installation- vehicle parts
Other:
Required
References
*
Please list two references other than relatives or friends.
Your answer
Do you have a driver's license?
*
Yes
No
What is your means of transportation to work?
*
Your answer
License number
*
Your answer
State of issue
*
Your answer
License Type
Operator
Commercial (CDL)
Chauffeur
Accident History
Please list any accidents or moving violations within the past three years.
Your answer
Have you ever been in the Armed Forces?
Yes
No
Clear selection
Are you now a member of the National Guard?
Yes
No
Clear selection
Military History
Please list your specialty, date entered, and discharge date as appropriate.
Your answer
Work Experience
*
Please provide a list of work experience from most recent to least recent for the last 5 years. Please include employer address, name of supervisor, dates of employment, salary, title, and reason for leaving.
Your answer
Additional Information
Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
Your answer
May we contact your current employer?
*
Yes
No
Other:
Did you complete this application yourself?
*
Yes
No
Other:
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