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Application for Employment
Pre-Employment Questionnaire
Equal Opportunity Employer
Personal Info
Name
*
First
Last
Suffix
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Primary Phone
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-
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Primary Phone
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Home
Cell
Other
Other Phone
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Other Phone
Home
Work
Cell
Other
Email
*
Employment Desired
What position are you applying for?
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Welding
RV Technician
Service Writer / Office / Admin
Other
Salary / Wage Desired
*
$
Dollars
.
Cents
Salary / Wage
*
Per hour
Per week
Per month
Would you like to upload a Resume?
Education History
School
*
Please select
High School Graduate
College Graduate
I did not complete High School
GED or Equivalent
Trade, Business, or Vocational School?
Please list any special training or certifications here.
Tell us about your skills
*
Special interest or studies, research work, special training, skills, experiences, or special abilities.
Former Employment
Current or most recent employer
Company
Position
Salary
Supervisor
Phone #
Reason for leaving
From
MM
/
YY
To
MM
/
YY
Previous Employer
Company
Position
Salary
Supervisor
Phone #
Reason for leaving
From
MM
/
YY
To
MM
/
YY
Previous Employer
Company
Position
Salary
Supervisor
Phone #
Reason for leaving
From
MM
/
YY
To
MM
/
YY
Previous Employer
Company
Position
Salary
Supervisor
Phone #
Reason for leaving
From
MM
/
YY
To
MM
/
YY
References
Reference 1
*
Name
Phone #
Business
Years Known
Reference 2
*
Name
Phone #
Business
Years Known
Reference 3
*
Name
Phone #
Business
Years Known
Criminal Background / History
Please choose one of the following statements
I do not have a criminal history
I do have a criminal history with misdemeanors only
I do have a criminal history with one or more felonies
If you do have a criminal history, please explain.
Include the actual conviction type and time incarcerated, if any. Please state if you are currently on parole or probation and for how long.
Authorization
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, previous employment, references, and all information obtained, and release J & S Trailer Service Inc and all associates of liability for any damage that may result from gathering or utilization of such information.
Signature
*
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