Application for Employment at Graham Tire Company

Application for Employment at Graham Tire Company
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status. There are two ways of submitting your application: 1. Fill out the form below online, click the "submit" button at the bottom of the form and your application will go to Graham Tire & Appliance. Use your tab key to move between fields and be careful not to hit your "enter" key or the form will automatically be sent. 2. Print out the application below and mail to: Graham Tire Company 1999 East Oxford Street Worthington, MN 56187 Attn: General Manager OR Fax to: 1-507-372-5841 First off, please type in your Full Name: (this is how we'll identify your application.)
Please provide the following contact information:
First Name:
Last Name:
Middle Initial:
Street Address:
Address (cont):
City:
State:
Zip Code:
Work Phone:
Home Phone:
Fax:
Please complete the information below:
Best time to contact you at home is:
If you are under 18 years of age, can you provide required proof of your eligibility to work?	Yes No N/A
Have you ever filed an application with us before?	Yes No
If Yes, give date
Have you ever been employed with us before?	Yes No
If Yes, give date
Do any of your friends or relatives, other than spouse, work here?	Yes No
Are you currently employed?	Yes No
May we contact your present employer?	Yes No N/A
Are you prevented from lawfulling becoming employed in this country because of Visa or Immigration Status? (proof of citizenship or immigration status will be required upon employment)	Yes No
Date available for work
What is your desired salary range?
Are you available to work
Are you currently on "lay-off" status and subject to recall?	Yes No
Can you travel if a job requires it?	Yes No
Please provide the following education information:
Elementary School please provide name and address of school
Course of Study
Number of years completed
Diploma/Degree

High School please provide name and address of school
Course of Study
Number of years completed
Diploma/Degree

Undergraduate College please provide name and address of school
Course of Study
Number of years completed
Diploma/Degree

Graduate/Professional please provide name and address of school
Course of Study
Number of years completed
Diploma/Degree

Other (please specify) please provide name and address of school
Course of Study
Number of years completed
Diploma/Degree

Please provide the following employment experience:
Employer Name
Employer Address
Employer Telephone Number
Job Title
Supervisor
Reason for leaving
Dates Employed
Hourly Rate / Salary
Work Performed

Employer Name
Employer Address
Employer Telephone Number
Job Title
Supervisor
Reason for leaving
Dates Employed
Hourly Rate / Salary
Work Performed

Employer Name
Employer Address
Employer Telephone Number
Job Title
Supervisor
Reason for leaving
Dates Employed
Hourly Rate / Salary
Work Performed

Employer Name
Employer Address
Employer Telephone Number
Job Title
Supervisor
Reason for leaving
Dates Employed
Hourly Rate / Salary
Work Performed

Please provide references:
Name
Address
Telephone Number

Name
Address
Telephone Number

Name
Address
Telephone Number

Applicant's Statement
I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee my resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.