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Employment Application
Step 1 of 2
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Applicant Information
Last Name
*
First Name
*
M.I.
*
Street Address
*
Apartment/Unit #
City
*
Phone
*
Email
*
Date Available
*
Social Security No.
*
Desired Salary
*
Position Applied For
*
Availability
*
Part Time
Full Time
From
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
To
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you 18 or older?
*
Yes
No
If no, how old are you?
Are you a citizen of the United States?
*
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
*
Yes
No
If so, when?
What prompted you to apply at Moo Moo Car Wash?
*
Newspaper
Sign
Friend/Relative
School placement office
Moo Moo's Website
Current Moo Moo's associate
Do you have reliable transportation to work?
*
Yes
No
Do you have a valid driver's license?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
If yes, explain
Education
High School
*
Address
*
From
*
To
*
Did you graduate?
*
Yes
No
Degree
College
Address
From
To
Did you graduate?
Yes
No
Degree
Other
Address
From
To
Did you graduate?
Yes
No
Degree
References
Please list three professional references.
Full Name
*
Relationship
*
Phone
*
Address
*
Full Name
*
Relationship
*
Phone
*
Address
*
Full Name
*
Relationship
*
Phone
*
Address
*
Previous Employment / Volunteer Work
Company
*
Phone
*
Address
*
Supervisor
*
Job Title
*
Starting Salary
*
Ending Salary
*
Responsibilities
*
From
*
To
*
Reason for Leaving
*
May we contact your previous supervisor for a reference?
*
Yes
No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
Military Service
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature
*
Date
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