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Application for Employment

"*" indicates required fields

Applicant Information

Full Name*

First Middle Last

Phone*

Email*

Current Address*

Street Address Address Line 2 City State ZIP Code

Employment Desired

Desired Position*

Desired Salary*

Date Available for Work*

Month

Day

Year

Are you employed now?*

Yes

No

Do you have the legal right to work in the United States?*

Yes

No

Have you ever been employed by this organization before?*

Yes

No

If yes, list dates of employment*

Towing Experience

Towing Industry Related Experience*

Summarize types of tow trucks you have operated and for how long, list any training related to the towing industry (i.e. AAA Certification, Commercial CDL, Mechanical Background)

Employment History

Current (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

To

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

No

Do you need to list another (second) employer?*

Yes

No

Second (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

To

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

No

Do you need to list another (third) employer?*

Yes

No

Third (Most Recent) Employer

Company Name*

Phone

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary

Dates Employed*

From

To

Reason for Leaving?*

May we contact your previous supervisor for a reference?

Yes

No

Do you need to list another (fourth) employer?

Yes

No

Fourth (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

To

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

No

Education

List of Education History*

Please enter each school that you attended, including high school, college, and trade schools if applicable. (Click the + button to add a new row)

School Name

Address

Years Attended

Did You Graduate?

Subjects Studies

Other Qualifications*

Please list any other qualifications which you have and which you believe would be important for consideration by the company pertaining to this application.

References

Please provide the Name, address, and telephone of four references who are not related to you and you have known for at least five years.

Reference 1*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 2*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 3*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 4*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Acknowledgement

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

Prospective applicants will receive consideration without discrimination because of race, color, religion, sex, national origin, age, marital or veteran status, non-job-related medical conditions or handicaps, or any other legally-protected status.

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.

Signature*

Full Name*

Date*

MM slash DD slash YYYY

Resume/File Upload (optional)

If you have a resume or additional documents you would like to attach, please do so here. This is not required.

Drop files here or

Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf, Max. file size: 5 MB, Max. files: 5.

Phone

This field is for validation purposes and should be left unchanged.

Van's Towing & Transport | Roseville, Michigan

29191 Groesbeck Hwy

Roseville, MI 48066

Call 586-775-5500

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Dispatch can also be reached at 586-300-3253

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