NOTICE TO APPLICANTS: This application form represents the minimum information required to be considered for a job at Parker Lube.


Date Position Applying for

  Personal Data
First Name MI Last Name
SS# Email
Is there another name in which educational and/or prior employment records may be listed? No Yes
Other Name
Address City State
Zip Telephone Message Phone
Date available for employment
To the best of your knowledge, are you related to any Parker Lube employee? No Yes
If yes, indicate: Name, Position and Relationship to You.
Have you ever been convicted of a felony? Yes No
If convicted of a felony, please explain.

  Education
  Name and Location Course of Study Years
Completed		 Certificate, Diploma
 or Degree
High School or Equivalent
Postsecondary Vocation School
College or University
Other Education/Special Training/
Military Schools

  Employment History
  (Current or most recent job first, then previous jobs in order)
Company Name Dates
Address
Supervisor Business Phone
May we contact your supervisor/employer? Yes No May we contact you at work? Yes No
Job title and duties
Company Name Dates
Address
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties
Company Name Dates
Address
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties
Company Name Dates
Address
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties

  References
Please list three professional references that have knowledge of your professional experience and who are in a position to evaluate your ability to perform the job that you are applying for.
Name Occupation Address Telephone

I certify that the information I have provided on this application is true, accurate and complete to the best of my knowledge.

I understand that any false statement, misrepresentation or willful omission of facts may prevent my being hired or, if hired, may cause termination from employment.

I understand that this application and records become the property of Parker Lube, Inc which reserves the right to accept or reject them

I authorize Parker Lube, Inc to conduct work history, personal reference, motor vehicle records checks or other criminal background inquiries to determine my acceptability for employment, and I release from liability any person giving or receiving any such information.

If hired, I will provide a medical and health history.

If hired, I will furnish documents required on Form I-9, Employment Eligibility Verification.

If hired I agree to observe all rules, regulations and policies of Parker Lube, Inc.

To apply for this position, click the "Submit Application" button to indicate that you understand and accept these terms. Your application will then be submitted. If you are the successful candidate, you will be asked to sign a copy of this application.

 

HOME