APPLICATION FOR EMPLOYMENT

Step 1 of 3

EMPLOYMENT HISTORY

The fact that you have filed this application will be kept confidential and will not be brought to the attention of your present employer without your permission. Please give an accurate, detailed and complete record of your employment below. Attach additional pages if necessary. “See Resume” is not acceptable for description of duties. BEGIN WITH YOUR MOST RECENT POSITION.

Employer:

Name

Employer Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone:

Dates Employed – From:

Start Date

To:

End Date

Position Held/ Job Title:

Job Responsibilities:

Supervisor:

Name

May we contact?

Yes

If no, why?

Starting Wages:

Final Wages:

Reason for leaving:

References

Please list names & contact information of work related references we may contact.

Work Related References:

Name:

Position:

Address and/or Phone

Number of Years Known

Use + sign to the right to add multiple references

To serve our diverse client base as well as our community, we are interested in whether you speak, read and/or write any languages other than English

Language:

What Level (fluent/good/fair):

Use + sign to the right to add multiple languages

Please List any and all special skills you may have that may benefit our company in the position you are applying for, such as software knowledge, technical training, certifications, and awards:

Use + sign to the right to add more than 3 skills

I hereby certify that answers provided are true and correct to the best of my knowledge. I also certify that I have a genuine intent and interest in employment with European Collision Center (here after referred to as company). I understand that any omission or misstatement of material fact on this application or any document used to secure employment shall be grounds for rejection of this application or for immediate discharge of employment if I am hired by company, regardless when it is discovered.

Initial:

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid drivers’ license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside. If employed by the company, I understand and agree that the company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles and computers) and in certain circumstances, my personal property. THIS COMPANY IS AN AT‐WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT‐WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT, EXPRESS OR IMPLIED, WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY.

Initial:

I also understand that (1) this company has a drug & alcohol free workplace policy that provides for preemployment testing as well as testing after employment: (2) consent to and compliance with such policy is a condition of my employment and (3) continued employment is based on the successful compliance with such policy. I understand fully that this application for employment is not a contract for or a guarantee of employment with European Collision Center.

Initial:

Name:

Date:

Signature:

Untitled