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The best driver we have ever worked with...
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Employment
Driver
Mechanic
Office Staff
Warehouse
©Copyright 1988 - 2010 Shelba D. Johnson Trucking, Inc.™, All Rights Reserved.

Mechanic Employment Application

Required fields are marked with an * asterisk.
  
    Signature of Applicant* (Typing Name Signifies Signature) 
              09/08/2010
                Date*
  Name:         Phone:*
                   First*      Middle*      Last*    Cell:*     
  *Current Address:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 
*If at the above residence less than three years, list below all residences for the past three years. Attach a separate sheet if necessary.
  Previous Address 1:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 
  Previous Address 2:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 
  Previous Address 3:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 
  Previous Address 4:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 
  Previous Address 5:   
    Street* 
  
    City / State / Zip* 
      
        How Long* 

Position Applying for:*                  
Who referred you?      Rate of pay expected?*
Have you worked for this company before?     Dates:    From
               month/year
   To
             month/year
Where?      Rate of Pay      Position
Reason for Leaving
Names of any relatives employed by this company
Are you currently employed?      If not, how long since leaving last employment?


EDUCATION

Select highest grade completed:
Last School attended?   
    Name
  
    Address


GENERAL

Have you ever been bonded?      Name of bonding company?
(Answer only if a job requirement)
Have you ever been convicted of a felony?
If yes, please explain fully below. Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.

Have you ever worked for this company under another name?      If, so, under what name?


EMPLOYMENT RECORD

The U.S. Department of Transportation requires that driver applicants show all employment for last three years. Effective July 1987 they
also show commercial driver employment for the seven years immediately preceeding this three year period. §391.21 (b)(10),(11).

   Current Employer:     Supervisor Name:    
   Address:*     Phone:    
   City:*     State:*     Zip:       Fax:    
   Position Held:     From:*     To:*     Salary:    
   Reason for Leaving:    

   Second Employer:     Supervisor Name:    
   Address:*     Phone:    
   City:*     State:*     Zip:       Fax:    
   Position Held:     From:*     To:*     Salary:    
   Reason for Leaving:    

   Third Employer:          Supervisor Name:    
   Address:*     Phone:    
   City:*     State:*     Zip:       Fax:    
   Position Held:     From:*     To:*     Salary:    
   Reason for Leaving:    

   Fourth Employer:        Supervisor Name:    
   Address:*     Phone:    
   City:*     State:*     Zip:       Fax:    
   Position Held:     From:*     To:*     Salary:    
   Reason for Leaving:    

   Fifth Employer:            Supervisor Name:    
   Address:*     Phone:    
   City:*     State:*     Zip:       Fax:    
   Position Held:     From:*     To:*     Salary:    
   Reason for Leaving:    


MAINTENANCE EXPERIENCE & QUALIFICATIONS

  List courses and training in maintenance below.
  

  Job Function
Indicate training and
experience in the following:
Formal Training Years of
Experience
Area Formal Training Years of
Experience
 Drive Line Components         Electrical Repair       
 Diesel Engine Tune-up and Rebuild         Frame and Wheel Alignment      
 Gas Engine Tune-up and Rebuild         Brakes       
 Tire Service         Cooling System       
 Trailer Repair         Inspections       
 Air Conditioning         General Car Repair       
 Body Work         

  Shop Equipment
Indicate training and
experience in the following:
Formal Training Years of
Experience
Area Formal Training Years of
Experience
 Electrical Diagnostic Equipment         Wheel & Tire Balancing Machine       
 Sheet Metal Equipment         Tire Re-capping Mold       
 Frame & Axel Straightening Equip.         Engine Dynamometer       
 Engine Rebuilding Equipment         Chassis Dynamometer       
 Diesel Injection Equipment         Magnetic Crack Detector       
 Electric Welder         Engine Analyzer       
 Oxycetylene Welder         Noise Measuring Equipment       
 Paint Spray Gun         Smoke Measuring Equipment       
 Air Conditioning         Inspections       
 Tire Service Machine         General Car Repair       



APPLICANT MUST READ AND SIGN

I certify that I have read and understand all of this employment application, and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize you to make such investigations and inquire of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.)

I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connections with my application.

It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an Investigative Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test. I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.

I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job.

I understand that false, misleading or omitted information from my application or interview(s) may result in my rejection as an applicant or discharge as an employee.

I understand, also, that I am required to abide by all rules and regulations of the Company.
09/08/2010
            Date*

  Signature of Applicant* (Typing Name Signifies Signature) 
 
  Email Address* 
ATTACHMENTS