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    * Date
    * Available Start Date
    * Employment
    Position of Choice
    Are you willing to accept other positions?


    CONTACT INFORMATION

    * First Name
    * Middle Name
    * Last Name
    * SSN
    * Address
    * City
    * State
    * Zip Code
    Home Phone
    Cell Phone
    * Email Address
    * Emergency Contact


    CONTACT INFORMATION

    Please show at least three years of past employment. Explain any gaps in employment.

    EMPLOYER 1

    EMPLOYER 2

    Employer
    Address
    Employer
    Address
    Start Date
    End Date
    Start Date
    End Date
    Position
    EPay Rate
    Position
    Pay Rate
    Reason for Leaving
    Reason for Leaving

    EMPLOYER 3

    EMPLOYER 4

    Employer
    Address
    Employer
    Address
    Start Date
    End Date
    Start Date
    End Date
    Position
    EPay Rate
    Position
    Pay Rate
    Reason for Leaving
    Reason for Leaving
    * Have you ever worked for Time-It Xpress Car Wash LLC in the past?

    Days or times NOT available to work?
    * Do you have any mechanical skills?
    * Have you ever attended an automotive class or school?

    Last school attended?
    * Highest grade completed?

    * You will not be automatically disqualified by your answers to the questions below.

    * Are you able or willing to work at any of our locations?
    * Do you have reliable transportation to get to work?
    * Do you have a valid driver license?

    * Do you have automobile liability insurance?
    * Are you 18 years of age or older?
    * Date of Birth?
    * Are you legally entitled to work in the U.S.?
    * Have you ever been convicted of a crime other than a minor traffic offense?
    Shirt/belt size?


    AGREEMENTS

    “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.”

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