Employment Application

Name:*
Address:*
Valid / Non Restricted Driver License No.:*
State Issued:*
Have you ever been convicted of a felony?*
If yes, explain:
Are you a disabled Veteran?*
Have you worked for us before?
If so, When?
Phone:*
-
E-mail:*
Position Applied for:*
Salary Desired:*
Date Available:*
Attach Resume:
If no, are you authorized to work in the U.S.?*
Are you a citizen of the United States?*
Are you currently or have you been a Welfare or TANF recipient within the last 18 months?
Are you currently or have you been a food stamp recipient within the last 6 months?*
Are you currently or have you been an SSI recipient within the last 60 days?*
Do you reside in one of the following counties:*

Education

HIgh School:*
High School Address:*
Did you Graduate from High School? *
Type of Degree received:*
High School (From):
High School (To):
College / University:
College Address:
Did you Graduate from College/University?
College Degree:
College/University (From):
College/University (To):
Technical Training:
Technical Address:
Technical (From):
Technical (To):
Technical Certification:
Professional Reference Name:*
Phone Number:*
-
What company do you know each other from?*
How long have you know each other?*
What is your relationship?*
(2) Professional Reference Name:*
(2) Phone Number:*
-
(2) - What company do you know each other from?*
(2) - What is your relationship?*
(2) - How long have you know each other?*
(3) - Professional Reference Name:*
(3) - Phone Number:*
-
(3) - What company do you know each other from?*
(3) - What is your relationship?*
(3) - How long have you know each other?*
Previous Employer:
Previous Employer's Address:
Previous Employer's Phone:
-
Employment To:
Employment From:
Job Title:
Responsibilities:
Reason for Leaving:
May we contact your Previous Employer for a Reference?
Starting Pay:
Ending Pay:
(2) Previous Employer:
(2) Previous Employer's Address:
(2) Previous Employer's Phone:
-
(2) Employment To:
(2) Employment From:
(2) Job Title:
(2) Responsibilities:
(2) Reason for Leaving:
(2) May we contact your Previous Employer for a Reference?
(2) Starting Pay:
(2) Ending Pay:
(3) Previous Employer:
(3) Previous Employer's Address:
(3) Previous Employer's Phone:
-
(3) Employment To:
(3) Employment From:
(3) Job Title:
(3) Responsibilities:
(3) Reason for Leaving:
(3) May we contact your Previous Employer for a Reference?
(3) Starting Pay:
(3) Ending Pay:
Military Branch Served:
Rank at time of Discharge:
Served From:
Served To:
Type of Discharge:
If other than honorable, explain:

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.

Type Name:
Date:

PRE-EMPLOYMENT, CONTINUED EMPLOYMENT DISCLOSURE

AUTHORIZATION, RELEASE FOR BACKGROUND CHECK AND DRUG SCREENING

I understand that in connection with my application for Employment and/or Continuous Employment, Premier Auto and RV, Inc., their agents or employees, may be performing, requesting, obtaining or conducting a background check on me. This background check may include an inquiry into my Employment History, Education, General Character or Reputation, Work Experience, Volunteer Experience, Driving, and/or Criminal History. If my position involves handling money and/or having access to monies and/or other transferable monetary instruments, my Credit History may also be checked.

I understand that Premier Auto and RV, Inc. may rely on any part of all of this Information in determining whether to extend an offer of Employment to me. I further understand that if any adverse action is taken Premier Auto and RV, Inc., or if Premier Auto and RV, Inc. should choose not to extend an offer of Employment to me based upon the Information, that I will be provided a copy of such Information along with a summary of my rights under the Fair Credit Reporting Act.

I understand that the background check, which may be performed by Investigators, is being performed as part of the process to evaluate me prior to Employment and is not conducted for any purpose other than in connection with my Application for Employment and/or my eligibility for Continued Employment.

I have read this Pre-Employment and Continued Employment and by signing below, hereby authorize Investigators to conduct a background check as described herein in conjunction with my application for employment. I hereby release any and all Investigators, including Premier Auto and RV, Inc. and its representatives from any and all liability related to the procurement or disclosure of any information provided by me or obtained about me in connection with my Application with Premier Auto and RV, Inc. I further direct and authorize Investigators to conduct the background check and further authorize any third parties who may be the custodians of or in possession of the requested Information, to disclose such Information to Investigators in connection with this background check.

Although furnishing your Social Security Number is not optional, it shall be used for NO other purpose than to make the process for conducting a background search more accurate. It shall not be sold, or in any way transferred to a third party except for the express purpose of conducting the background check.

All applicants for employment, including part-time and seasonal positions and applicants who are former employees, are subject to drug and alcohol testing. An applicant must pass the drug test to be considered for employment. An applicant will be provided written notice of this policy and by signature will be required to acknowledge receipt and understanding of the policy. If an applicant refuses to take a drug or alcohol test, or if evidence if the use of illegal drugs or alcohol by an applicant is discovered, either through testing, or through other means, the pre-employment process will be terminated.

Candidate's Name:
Date of Birth:*
Former Last Name(s) if applicable:
Current Address:*
Former Address:*
Candidate's Signature*
Application Date:*