ProntoWash

Applicant Information (Step 1 of 4)

First Name:

Last Name:

Street Address:

City:

ZIP/Postal Code:

Apartment/Unit #:

State:

Phone:

E-mail Address:

Date Available:

Social Security No.:

Desired Salary ($):

Position Applied for:

Are you a citizen of the United States?
yes no

If no, are you authorized to work in the U.S.?
yes no

Have you ever worked for this company?
yes no

If so, when?

Have you ever been convicted of a felony?
yes no

If yes, explain:

Education (Step 2 of 4)

High School:

From:

Did you graduate?
yes no

Address:

To:

Degree:

College:

From:

Did you graduate?
yes no

Address:

To:

Degree:

Current or Last Employment (Step 3 of 4)

Company:

Address:

Job Title:

Starting Salary ($):

From:

Reason for Leaving:

Phone:

Supervisor:

Responsibilities:

Ending Salary ($):

To:

Disclaimer and Signature (Step 4 of 4)

We are an equal opportunity employer. Federal and State laws, and our personnel policies prohibit discrimination in employment because of race, color, creed, age, sex, sexual orientation, marital status, national origin, physical or mental impairment, or medical condition.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

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