Position Applying for
Full Name
Other names under which you have attended school or been employed:
Street Address
City, State & Zip
Social Security Number
Home Phone
Work Phone
Other Phone
If NO, what is your current age?
If YES, what is your current job title & department?
If YES, dates of employment & reason for leaving:
If YES, their name & their relationship to you?
If YES, State of issuance, license #, and expiration date:
High School
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
GED
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
Other School
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
College
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
College
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
College
City/State
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.
Skills
Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)
WORK EXPERIENCE -Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT complete this information with the notation “See Resume.”
PLEASE NOTE: Graham Collision “GBS Inc” reserves the right to contact all current and former employers for reference information.
Dates Employed (most recent position)
From
To
If part-time, # hrs./wk:
Title
Starting Salary
Final Salary
Organization Name and Address:
Supervisor’s Name, Title and Phone #:
Other Reference Name, Title and Phone #:
Primary duties:
Reason for Leaving:
Please list 3 references, not related.
Name
Phone Number
Name
Phone Number
Name
Phone Number
PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully
complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after
employment if discovered at a later date. I authorize Graham Collision “GBS Inc.” to investigate, without liability, all statements contained in this
application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection
with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening
for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of
employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of Graham Collision “GBS Inc.”
serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law.
If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to
comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would
be ineligible for benefits including paid time off. If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory
contributions to the Graham Collision “GBS Inc.” Retirement System or to an optional retirement program, if applicable. I understand that any benefits I receive may be
subject to change or discontinuation at any time without prior notice. I understand that the first SIX MONTHS of regular employment represent a
provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.
Signature
Date
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