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Pit Stop Car Wash Employment Application
Personal Information
Social Security Number*

E-Mail Address:*

First Name:*

Middle Initial

Last Name:*

Preferred Nickname:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Home Phone:*

Business Phone:

Cell Phone:

Work Preference
Date Available*

Postion Applied For:*

Minimum Acceptable Anual Salary:*

Employment Requested:*
Full Time
Part Time
Temporary

Work Shift Availability - Put a check on the days/shifts that you are available
Monday Open

Tuesday Open

Wednesday Open

Thursday Open

Friday Open

Monday Close

Tuesday Close

Wednesday Close

Thursday Close

Friday Close

Saturday Open

Sunday Open

Saturday Close

Sunday Close

Education
High School Name/Location:

Diploma Received:*
Diploma
Equivalency
None

College Name/Location:

Degree Earned:

Attended from:

Attended To:

Major/Minor:

Other School:

Degree Earned:

Attended from:

Attended To:

Major/Minor:

Employment History
Name Of Employer:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Employed From:*

Employed To:*

Employer Phone:*

Job Title:*

Supervisor Name:*

Reason For Leaving:*

Name Of Employer:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Employed From:*

Employed To:*

Employer Phone:*

Job Title:*

Supervisor Name:*

Reason For Leaving:*

Skills Section
Please list any subjects of special study, training, skills, etc.*

Why do you want to work for Pit Stop Car Wash and why would you be good for our company?*

Professional References
Please list three references that have knowledge of your professional experience.
Reference Name:*

Address:*

Occupation:*

Phone:*

Reference Name:*

Address:*

Occupation:*

Phone:*

Reference Name:*

Address:*

Occupation:*

Phone:*

Background
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR A FIRST DEGREE MISDEMEANOR?
*
Yes No 

ARE YOU A U.S. CITIZEN OR ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.?
*
Yes No 

ARE YOU 18 YEARS OF AGE OR OLDER?
*
Yes No 

Anything else you would like us to consider with your application?*

Resume Upload:

BY SUBMITTING THIS APPLICATION, I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.
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