PDF Employment Application Store#687 - Baltimore MD Jiffy Lube ...

APPLICANT INFORMATIONFULCO FRANCHISE GROUPEMPLOYMENT APPLICATIONStore# 6872071 York RoadBaltimore, MD 21093Last Name First M.I. DateStreet Address Apartment/Unit #City State ZIPPhoneE-mail AddressDate Available Social Security No. Desired SalaryPosition Applied forAre you a citizen of the United States? YES NO If no, are you authorized to work in the U.S.? YES NOHave you ever worked for this company? YES NO If so, when?Have you ever been convicted of a felony? YES NO If yes, explainEDUCATIONHigh SchoolAddressFrom To Did you graduate? YES NO DegreeCollegeAddressFrom To Did you graduate? YES NO DegreeOtherAddressFrom To Did you graduate? YES NO DegreeREFERENCESPlease list three professional references.Full NameRelationshipCompany Phone ( )AddressFull NameRelationshipCompany Phone ( )AddressFull NameRelationshipCompany Phone ( )Address

PREVIOUS EMPLOYMENTCompany Phone ( )AddressSupervisorJob Title Starting Salary $ Ending Salary $ResponsibilitiesFrom To Reason for LeavingMay we contact your previous supervisor for a reference? YES NOCompany Phone ( )AddressSupervisorJob Title Starting Salary $ Ending Salary $ResponsibilitiesFrom To Reason for LeavingMay we contact your previous supervisor for a reference? YES NOCompany Phone ( )AddressSupervisorJob Title Starting Salary $ Ending Salary $ResponsibilitiesFrom To Reason for LeavingMay we contact your previous supervisor for a reference? YES NOMILITARY SERVICEBranch From ToRank at DischargeType of DischargeIf other than honorable, explainDISCLAIMER AND SIGNATUREI certify that my answers are true and complete to the best of my knowledge.If this application leads to employment, I understand that false or misleading information in my application or interviewmay result in my release.SignatureDate