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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:*
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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:*
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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:*
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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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