Tire World is proud to offer a drug free workplace.
We reserve the right to conduct pre-employment drug screening.

Please include all possible information

PERSONAL INFORMATION
First Name Last Name Middle Name Social Security No.
Present Address City State   Zip
Permanent Address City State   Zip
Home Phone Other Phone E-mail Address  
Are You 18 Years old or older?      Yes   No    
Are you either a U.S. citizen or an alien authorized to work in the United States? Yes   No

EMPLOYMENT DESIRED
Position Date you can start. salary desired
Are you empolyed now?  Yes    No May we inquire of your present employer? Y N
Ever applied to this company before?  Y N When? 
Referred by:    

EDUCATION
  Name and location of school Years Attended Did you graduate? Subjects Studied
Grammar School Y N
     
High School Y N
     
College Y N
     
Trade,  Buisness or Other School Y N
   

GENERAL

.Subjects of special study or research work

Special Skills

Activities - Civic, Athletic, etc.
(Note - Please exclude organizations where the name indicates the race,
creed, sex, age, marital status, color or nation of origin of it's members.)

MILITARY SERVICE
Present membership in National Guard or Reserves ?  Y    N
Branch Rank

EMPLOYMENT HISTORY

List last 4 employers with most recent or current first.
Dates, Month & Year Name & address of Employer Salary Position Reason for leaving
From
To
From
To
From
To
From
To

Which of these jobs did you like best?

What did you like most about this job?

REFERENCES

List 3 references not related to you that you have known for at least 1 year.
Name Address Business Years Known
     
     
     

"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 listed above to give you any and all information regarding my previous employment and any pertinent information they may have and release all parties from all liabilities for any damage that may result from furnishing such to you.

I authorize Tire World, Inc. to conduct a pre-employment drug screening.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice or cause."

"By submitting this application I agree to all of the above statements."