VR-Application-for-Employment

APPLICATION FOR EMPLOYMENT

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color,
religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

Answer all questions. Please, print. If the answer to any questions is “No” or “None”, do not leave the item blank, but write “No” or “None”.

Type

Street
City
State
Zip Code
yr./mo.

Street
City
State
Zip Code
yr./mo.

Are you 18 years of age or older?
A. Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
B. Has any license, permit, or privilege ever been suspended or revoked?
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you ever worked for this company before?
Are you employed now?

EMPLOYMENT HISTORY

Please, list your work experience for the past TEN years beginning with your most recent job held.
If you were self-employed, give firm name. Attach additional sheets if necessary.

EMPLOYER

DATE

FROM
MO.
YR.

DATE

TO
MO.
YR.

MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A REFERENCE?

EMPLOYER

DATE

FROM
MO.
YR.

DATE

TO
MO.
YR.

MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A REFERENCE?

EMPLOYER

DATE

FROM
MO.
YR.

DATE

TO
MO.
YR.

MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A REFERENCE?

EMPLOYER

DATE

FROM
MO.
YR.

DATE

TO
MO.
YR.

MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A REFERENCE?

EMPLOYER

DATE

FROM
MO.
YR.

DATE

TO
MO.
YR.

MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A REFERENCE?

EDUCATION

1 2 3 4 5 6 7 8 9 10 11 12
1 2 3 4
(NAME)(CITY, STATE)

EXPERIENCE AND QUALIFICATIONS – PLATFORM

EXPERIENCE AND QUALIFICATIONS – MAINTENANCE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

SHOW EQUIPMENT YOU CAN OPERATE

EXPERIENCE AND QUALIFICATIONS – OTHER

MILITARY SERVICE

TO BE READ AND SIGNED BY APPLICANT

It is agreed and understood that any misrepresentation given above shall be considered an act of dishonesty.
It is agreed and understood that Vermillion Repair Shop, LLC (hereinafter called “the Company”) or its agents may
investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is
of record or not, and applicant releases employers and persons named herein from all liability for any damages on account
of his/her furnishing such information.
It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I understand that this
investigation may include an Investigating Consumer Report, including information regarding my character, general
reputation, personal characteristics, and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my
employment file.
It is agreed and understood that this application for qualification in no way obligates the Company to employ the applicant.
It is agreed and understood that if qualified, the employee may be on a probationary period during which time he may be
disqualified without recourse.
It is agreed and understood that, if hired, my employment with the Company is on an At-Will basis. Employment is not a
contract and the employer and/or employee can discontinue the employment relationship at any time.

This certifies that this application was completed by me, and that all entries on it and information in it 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