In compliance with Federal and
State equal employment opportunity laws,
qualified applicants are considered for all
positions without regard to race, color,
religion, sex, national origin, age, marital
status, or non-job related disability.
|
|
|
Position (s) Applied for |
|
First Name: |
|
Last Name: |
|
Contact Number: |
|
SSN# xxx-xxx-xxxx |
|
Address |
|
City |
|
State |
|
Zip |
|
|
Do you have the legal right to work in the
United States? |
Yes |
No |
Date of Birth |
/ / |
Can you provide proof of age? |
Yes |
No |
Have you ever worked for this company before |
Yes |
No |
If Yes - Where? |
|
Dates: From
To: |
Rate of Pay: |
Position: |
|
Reason for leaving |
|
Are you now employed |
Yes |
No |
If not, how long since leaving last
employment? |
Month(s) Year(s) |
Who referred you? |
|
Rate of pay expected |
|
|
Is there any reason you might be
unable to perform the functions of the job for
which you have applied.
Yes
No |
If yes, explain if you wish.
|
If you are accepted for a
position with ALN - American Limo Network - are you able to provide a complete
10 year history of past employment - no
gaps - including vacations and
unemployment periods?.
Yes
No |
If the answer is No, please explain
|
|
Accident Record for Past 3 years
or more - if none, write NONE
|
Dates |
Nature of
Accident
(Head-On,
Rear-End, Upset, Etc.) |
Fatalities |
Injuries |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Traffic Convictions and
Forfeitures for the Past 3 Years
(other than parking violations) if
none, write NONE - in location field
|
|
|
Education
|
|
|
Experience and Qualifications -
Driver
|
|
|
|
|
|
Driving Experience - If none,
write NONE
|
|
|