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Higher Up There

In:

Submitted By jgunther112
Words 1430
Pages 6
LEVIN TIRE & SERVICE CENTER
APPLICATION FOR EMPLOYMENT
(PRE-EMPLOYMENT QUESTIONNAIRE) (AN EQUAL OPPORTUNITY EMPLOYER)
IMPORTANT: You must immediately save this application before proceeding. Once complete, re-save the application, and then upload as indicated.

PERSONAL INFORMATION

DATE

__________________

SOCIAL SECURITY NO.

__________________

NAME____________________________________________________________________________________________
FIRST
LAST
MIDDLE
PRESENT
ADDRESS_________________________________________________________________________________
STREET
CITY
STATE
ZIP
PREVIOUS
ADDRESS________________________________________________________________________________
(IF LESS THAN FIVE YEARS)
STREET
CITY
STATE
ZIP
HOME PHONE____________________________

CELLULAR PHONE_______________________________

E-MAIL ADDRESS________________________

GENERAL INFORMATION
ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY BECAUSE OF VISA
NO
OR IMMIGRATION STATUS?
YES
ARE YOU 18 YEARS OR OLDER?

YES

NO

HAVE YOU BEEN CONVICTED OF A CRIME, EXCLUDING MISDEMEANORS AND SUMMARY OFFENSES,
(PLEASE NOTE THIS REQUEST DOES NOT INCLUDE A REQUEST FOR INFORMATION CONCERNING ANY
NO
IF
CONVICTIONS THAT HAVE BEEN ANNULLED, EXPUNGED OR SEALED BY A COURT)? YES
“ YES” PLEASE DESCRIBE IN FULL. PLEASE NOTE THAT THIS INFORMATION DOES NOT DISQUALIFY
APPLICANT FROM BEING HIRED WITH LEVIN TIRE. THE RELEVANCE OF THE OFFENSE TO THE
POSITION (S) APPLIED FOR MAY, HOWEVER, BE CONSIDERED.
_____________________________________________________________________________________________

___________________________________________________________________________________________________________

__________________________________________________________________________________________________
HAVE YOU EVER WORKED FOR THE LEVIN TIRE &

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