Buckeye Super Wash Job Application
Please complete the following information in detail.
First Name
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Middle Name
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Last Name
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Date of this Application
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YYYY
Street Address
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City
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Zip Code
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State
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Telephone
Best Number to reach you
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Email
Best email to reach you
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If under 18, please list current age:
Please note, if under the age of 18, a work certificate may be needed
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Position applied for
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Hourly Pay Rate Desired
Please be specific.
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Days available
Required
Type of employment desired
How many hours can you work weekly?
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Are you available to work any shift between 7:30 am - 7:30 pm
Required
I'm able to work outdoors during hot or cold weather?
Required
I'm able perform labor related tasks up to and including lifting 25lbs?
Required
When are you available to start work?
Educational History
Please list all educational history, including a list of high school, or technical schools attended (name + address), # of years completed, and any major/degree.
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Office/ Trade Skills
Please check any skills you have.
Required
References
Please list two references other than relatives or friends.
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What is your means of transportation to work?
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Do you have a valid driver's license?
State of issue
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License Type
Accident/Violation History
Please list any accidents or moving violations and points on license within the past three years.
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Have you ever been in the Armed Forces?
Are you now a member of the National Guard?
Military History
Please list your specialty, date entered, and discharge date as appropriate.
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Work Experience Past 5 years
PLEASE READ CAREFULLY: provide a list of work experience from most recent to least recent for the last 5 years. Please include employer name/full address, name of supervisor, dates of employment, pay rate, title, responsibilities, and reason for leaving.
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Additional Information
Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
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May we contact your current employer?
Did you complete this application yourself?
Have you ever been convicted of a crime?
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
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We are a Drug-Free, Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.
READ CAREFULLY: I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give any and all information concerning my previous employment, credit history, criminal record and any other pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing this information.
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