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Employment Application

Collision Revision is an equal opportunity employer. Collision Revision affords equal opportunity to all applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, veteran status or any other status protected under local state or federal laws.

= Required

Personal Information

Legal First Name: *
Legal Last Name: *
Middle Initial:
Date Completed: *
Home Address: *
City/State: *
Zip Code: *
County:
Home Telephone Number: *
Mobile Telephone Number:
Email Address:
Location Desired: *
Position Desired: *
Available Start Date: *
Wage Desired: *
Have you been employed with our company in the past?

If yes, what was the:

Company:
Date:
Location:
Are you legally authorized to work in the United States?

Desired Employment Type:

What shift(s) are you available to work?

Employment History

Begin with Most Recent Employment

Job 1
Dates From: * To: *
Company Name: * City/State: *
Title(s): * Brief description of duties: *
Supervisor's Name: * Telephone Number: *
Reason for Leaving: *

Job 2
Dates From: To:
Company Name: City/State:
Title(s): Brief description of duties:
Supervisor's Name: Telephone Number:
Reason for Leaving:

Job 3
Dates From: To:
Company Name: City/State:
Title(s): Brief description of duties:
Supervisor's Name: Telephone Number:
Reason for Leaving:

Are you currently employed?
May we contact your present employer?
Have you been convicted of any moving violations in the past 5 years?
If yes, please explain:
Have you ever been convicted of a felony?
If yes, please explain:

Education

High School
School Name:
School City/State:
Degree & Number of Years Completed:

College/University
School Name:
School City/State:
Degree & Number of Years Completed:

Vocational/Technical
School Name:
School City/State:
Degree & Number of Years Completed:

Technical Training

OEM Certifications, I-CAR, ASE, Fork Lift Training, etc.

Technical Training 1
Subject:
Date of Certification:
Course Description:

Technical Training 2
Subject:
Date of Certification:
Course Description:

Technical Training 3
Subject:
Date of Certification:
Course Description:

References

Please give the name of three persons not related to you

Person 1
Name: *
Occupation: *
Relationship: *
Telephone: *

Person 2
Name: *
Occupation: *
Relationship: *
Telephone: *

Person 3
Name: *
Occupation: *
Relationship: *
Telephone: *

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application of employment shall be considered active for a period of time not to exceed 365 days. If I wish to be considered for employment after this period I must fill out and submit a new application.

I understand that if offered a position with the Company, I may be required to submit a pre-employment medical examination, drug screening, motor vehicle record and background check as a condition of employment. I understand that any un-satisfactory results from refusal to cooperate with, or any attempt to affect the results of these pre-employment tests and checks will result in withdrawal of any employment offer or termination of employment if already employed.

I acknowledge that I have read, understood and agree to the above statements.