JOHNSON’S TIRE SERVICE, LLC Employment Application Applicant Information Full Name: Address:
Phone:
___________________________
__________________________
____
Last
First
M.I.
Date:
________________
______________________________________________ __________
____________________________ __
Street Address
Apartment/Unit #
______________________________________________ __________
__________
_________________
City
State
ZIP Code
(___) _______________________________
Date Available:
___________
Type of Employment
_____________________________________
E-mail Address: YES
NO
Alaska Drivers Lic.
Position Applied for:______________________
Full-Time ______________ Part-Time _____________Temporary until (Date)_________________ YES
NO
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the U.S.? YES
NO
YES
NO
Have you ever worked for JTS/JMJ before?
If yes, when?
Have you ever been convicted of a felony?
____________________________________
If yes, explain: __________________________________ ____
______________________________________________ ________________________________ ___________________ ______________________________________________ ______________________________________________ _______
Education High School: From:
___________________________ _______
To:
________
YES
_______
Other:
_______________________________
From:
_______
To:
________
________
NO
Address:
Degree:
NO
Did you graduate? Address:
__________________________
______________________________________________ __ YES
From:
To:
______________________________________________ __
Did you graduate?
____________________________
College:
Address:
Degree:
__________________________
______________________________________________ __ YES
NO
Did you graduate?
Degree:
__________________________
References Please list three professional references. Full Name:
____________________________________
Company:
______________________________________________ ____
Address:
Relationship:
____________________________________
Company:
______________________________________________ ____
Relationship:
(____) _____________________
_____________________________________ Phone:
(____)_____________________
______________________________________________ ____________________________________________
Full Name:
____________________________________
Company:
______________________________________________ ____
Address:
Phone:
______________________________________________ ____________________________________________
Full Name:
Address:
_____________________________________
Relationship:
_____________________________________ Phone:
(____)_____________________
______________________________________________ ____________________________________________
Previous Employment Company:
______________________________________________ __
Phone:
Address:
______________________________________________ __
Supervisor:
Job Title:
__________________________
Responsibilities: From:
Starting Salary:
$_______
(____) _____________________ __________________________ Ending Salary:
$____________
______________________________________________ ______________________________________
__________
To:
_________
Reason for Leaving:
___________________________________________
YES
NO
May we contact your previous supervisor for a reference? Company:
______________________________________________ __
Phone:
Address:
______________________________________________ __
Supervisor:
Job Title:
__________________________
Responsibilities: From:
Starting Salary:
$_______
(____) _____________________ __________________________ Ending Salary:
$____________
______________________________________________ ______________________________________
__________
To:
_________
Reason for Leaving:
___________________________________________
YES
NO
May we contact your previous supervisor for a reference? Company:
______________________________________________ __
Phone:
Address:
______________________________________________ __
Supervisor:
Job Title:
__________________________
Responsibilities: From:
Starting Salary:
$_______
(____) _____________________ __________________________ Ending Salary:
$____________
______________________________________________ ______________________________________
__________
To:
_________
Reason for Leaving:
___________________________________________
YES
NO
May we contact your previous supervisor for a reference?
Military Service Branch:
______________________________________________ _____
Rank at Discharge:
___________________________
From:
Type of Discharge:
________
To:
______________
______________________________
If other than honorable, explain: ______________________________ _________________________________________ ______________________________________________ ______________________________________________ _______
Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature:
Date: