PALMER'S GARAGE EMPLOYMENT STATEMENT

Palmer's Garage reaffirms its commitment to Equal Employment Opportunity and will recruit, hire and promote persons in all job categories without discrimination to race,color,religion,sex,sexual preference,veteran status, national origin, age or handicap.

PLEASE FILL IN THE FOLLOWING INFORMATION COMPLETELY IF APPLYING FOR EMPLOYMENT.

Name:____________________________________Date:__________________

Address:_________________________________________________________

Telehone #__________________________Cell #_________________________

DOB: _________ SS#_________________Drivers License #________________

Marital Status: Married____Single___Widowed____Divorced___Separated___

Job Applying For:__________________________________________________

Referral:_________________________________________________________

_________________________________________________________________

POSITION APPLYING FOR
Towing ______ Have you had any previous towing experience Yes _____ No _____

Mechanic _____ Date you would be available to start _____________________

Have you ever filed an application with us before today? Yes _____ No _____ If yes give date:_________

Are you currently employed? Yes _______ No ________

Have you ever been convicted of a felony within the last 7 years? Yes _____ No_____

If yes, please explain _________________________________________________________________

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Has any license, permit or privilege ever been suspended or revoked?

EMPLOYMENT

MAY WE CONTACT YOUR PRESENT EMPLOYER:  Yes ___  No ____

__________________________________________________________________________        

Company Name                                                                          Telephone #        Dates Employed

Address                                                         City                                      State                         Zip Code

Reason for leaving                                                                                               Supervisors Name