ACCU-TUNE N LUBE AUTOMOTIVE SERVICE CENTER

Application for Employment

All statements made by applicants for employment on this application form will be checked for accuracy. We offer equal employment opportunities to all persons without discrimination on the basis of race, color, religion, age, marital status, sex, national origin, citizenship status, physical or mental disability, or past, present or future service in the Uniformed Services of the U.S., or any other legally protected status. The use of this form does not mean there are positions open and does no obligate us in any way.

Personal Information

Your Name:*
Present Address:
Address 2:
City:
State, Zip Code:
Home or Nearest Phone:*
Emergency Phone Number:
Email:*
Social Security Number:

If at present address for less than one year, please give previous address:
Address:
Address 2:
City:
State, Zip Code:

Are you over the age of 18?	Yes No
Can you produce documented proof of your identity and eligibility for employment in the United States? (Examples: driver's license, Social Security card, birth certificate, and/or Immigration and Naturalization Service Documents.) Yes No

Position Information

Position(s) applied for:
Type of employment:	Full-Time Part-Time Temporary
What days and hours if part-time?
Days:
Hours:
From:	To:
How soon could you report to work?
Rate of pay expected:

Education
High School
Name & Address of High School:
Courses Majored In:
Grade Completed:	9 10 11 12
Graduate?	Yes No

College
Name & Address of College
Courses Majored In:
Years Completed:	1 2 3 4
Graduate?	Yes No

Additional Information

Have you applied for a job with us before?	Yes No
Have you ever worked for us before?	Yes No
How did you come to apply?	Employee Referral Former Employee Newspaper Ad High School Recruitment College Recruitment Walk-in Other:
Have you ever been bonded?	Yes No
Have you ever refused a bond?	Yes No
Have you ever served in the U.S. Uniformed Services?	Yes No
If yes, branch:
Date entered:
Date discharged:
Have you ever been convicted of a violation of the law except a minor traffic violation?	Yes No
If so, state date, court and place where offense occurred:
Have you ever been discharged or requested to resign from a position?	Yes No
Are you employed now?	Yes No
If yes, may we contact your present employer?	Yes No
Why do you desire to make a change?
Have you ever held a position of trust (handling money or confidential material)?	Yes No
Do you have any reason to believe that you would have difficulty meeting this company's work schedule?	Yes No
If yes, explain:

Certifications and Licenses

Indicate number of ASE Automobile certifications you possess: N/A 1 2 3 4 5 6 7 8 Indicate number of ASE Truck certifications you possess: N/A 1 2 3 4 5 6 7 8 Do you possess ASE L1 (advanced engine performance)? N/A Yes No Do you possess a refrigerant recovery & recycling certification? N/A Yes No Do you possess a current VA State Safety Inspector License? N/A Yes No

Employment Information

1. Most Recent Employer:
Address:
Address 2:
Phone:
Supervisor:
Date Hired:
Date Left:
Starting Rate:
Ending Rate:
Reason for Leaving:
May we contact this employer?	Yes No

2. Former Employer:
Address:
Address 2:
Phone:
Supervisor:
Date Hired:
Date Left:
Starting Rate:
Ending Rate:
Reason for Leaving:
May we contact this employer?	Yes No

3. Former Employer:
Address:
Address 2:
Phone:
Supervisor:
Date Hired:
Date Left:
Starting Rate:
Ending Rate:
Reason for Leaving:
May we contact this employer?	Yes No

Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you feel will be helpful to us in considering your application.


References

Name:
Address:
Address 2:
Phone:

Name:
Address:
Address 2:
Phone:

Name:
Address:
Address 2:
Phone:

1613 Indepenence Blvd, Virgina Beach, VA

1132 Lynnhaven Parkway, Virginia Beach, VA

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