Earnhardt's Application for Employment Click here for a printable version Read before continuing: Applicant's Statement I have read the Applicant's Statement mentioned above: Yes No Read before continuing: Employer's Intent to Obtain Consumer Report I have read and accept the Employer's Intent to Obtain Consumer Report mentioned above: Yes No        I (name) (ssn) hereby consent to and authorize Earnhardt Auto Centers to obtain and utilize (Employer) information provided by a consumer reporting agency. I acknowledge that I have read the written disclosure statement of Earnhardt's intent to obtain information from a consumer reporting agency about me. I further authorize Earnhardt's to use the information for purposes of considering me for employment, promotion, reassignment, retention, demotion or termination.

Description of Job desired:     Full Time   Part Time

Personal Data:
First Name:	Middle Name:	Last Name:

Present Address: Street and Number City, State, Zip How Long have you lived there? Years               Months

Previous Address: Street and Number City, State, Zip How Long did you live there? Years               Months

Phone Number:

Social Security #:

E-mail Address:

Are you 18 years of age or older? YES:   NO: Have you ever worked for this Company before? YES:   NO: If Yes, Please give dates and position: Do you have any friends or relatives working here? YES:   NO: If Yes, Name: If a driver's license is required for the position for which you are applying, do you have a valid driver's license? YES:   NO:

License Number:

License State:

License Expiration:

Have you been cited for a traffic violation of any kind within the last FIVE years? YES:   NO: If Yes, Please give date and details: NOTE: An affirmative answer to the following question will not automatically disqualify you from consideration for the position for which you are applying. Factors such as age of the conviction, time of events, seriousness and nature of the violation, and rehabilitation are taken into account. Have you ever pled guilty or "no contest" to a crime or been convicted of a crime? YES:   NO: If Yes, Please give date and details of each: Are you capable of satisfactorily performing the essential job duties required of the position for which you are applying? YES:   NO:

Education:	Elementary	High	College/ University	Graduate/ Professional
School Name
Years Completed	4:  5:  6:  7:  8:	9:  10:  11:  12:	1:  2:  3:  4:	1:  2:  3:  4:
Diploma/Degree and Major Course of Study
Describe Specialized Training, Military Experience, Skills, and Extra-Curricular Activities

Record of Previous Employment: Please list the names of your previous employers in chronological order with present or last employer listed first. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references.

Name of Present or Last Employer:	Employed From:(mo./yr.)	Employed To: (mo./yr.)	Your Title or Position
Address:
City, State, Zip:	Starting Pay:	Final Pay:	Name of last Supervisor:
Telephone:
Reason for Leaving:

Previous Employer:	Employed From:(mo./yr.)	Employed To: (mo./yr.)	Your Title or Position
Address:
City, State, Zip:	Starting Pay:	Final Pay:	Name of last Supervisor:
Telephone:
Reason for Leaving:

Previous Employer:	Employed From:(mo./yr.)	Employed To: (mo./yr.)	Your Title or Position
Address:
City, State, Zip:	Starting Pay:	Final Pay:	Name of last Supervisor:
Telephone:
Reason for Leaving:

Previous Employer:	Employed From:(mo./yr.)	Employed To: (mo./yr.)	Your Title or Position
Address:
City, State, Zip:	Starting Pay:	Final Pay:	Name of last Supervisor:
Telephone:
Reason for Leaving:

Previous Employer:	Employed From:(mo./yr.)	Employed To: (mo./yr.)	Your Title or Position
Address:
City, State, Zip:	Starting Pay:	Final Pay:	Name of last Supervisor:
Telephone:
Reason for Leaving:

Have you ever been terminated or asked to resign from any job? YES:   NO: If Yes, Please Explain Circumstances: Please explain fully any gaps in your employment history: May we contact your current employer? YES:   NO: If NO, Please Explain:

Character References: Please list persons who know you well -- Not previous employers or relatives
Name	Occupation	Full Address	Telephone #	No of Years Known

Additional Information: - Please indicate any actual experience you have in any of the following positions: Select as many as apply by Ctrl-Clicking: (Mac Users must use Shift-Click)
Office Scroll down Office Manager Bookkeeper Accounts Rec. Accounts Pay. Payroll Clerk Tag/Title Clerk Warranty Clerk Data Entry Cashier	Sales/Leasing Scroll down Sales Manager Sales (New Car) Sales (Used Car) Sales (Truck) F & I Manager Leasing Manager Fleet Manager Truck Manager Used Car Manager	Service & Repair Scroll down Service Manager Service Writer/Advisor Dispatcher Shop Foreman Mechanic / Tech. Electrician Helper Painter Body Repair Get Ready	Parts Scroll down Parts Manager Parts Counter Parts Stocker Parts Driver

Additional Comments: This application will be considered active for a maximum of thirty (30) days. If you wish to be considered for employment after that time, you must reapply. I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE AND ACCURATE. Click the box to signify aggreement: