First Name

Middle Name

Last Name

Current Address

Zip

City

State

Home Phone

Cell Phone

E-Mail Address

Emergency Contact

How were you referred to the company?

Position you apply for Position you apply forAre you applying for Regular Full-Time work?Regular Part-Time Work?Temporary Work?Event, on-Call

If hired, what date can your start work?

Can you work weekends? Can you work weekends? Yes No

Can you work overtime? Can you work overtime? Yes No

Can you drive a stick shift? Can you drive a stick shift? Yes No

Can you work evenings? Can you work evenings? Yes No

Do you have a valid driver license? Do you have a valid driver license? Yes No

Have you ever applied to/worked for Valet Connect before? Have you ever applied to/worked for Valet Connect before? Yes No

Please explain and include dates for prior work:

May we contact your current employer? May we contact your current employer? Yes No

Have you ever been convicted of a crime or any violation of the law other than minor traffic violations? Have you ever been convicted of a crime or any violation of the law other than minor traffic violations? Yes No

Are there any felony charges pending against you? Are there any felony charges pending against you? Yes No

Please Explain

Do you have any experience, special skills or training that you feel we should be aware of that makes you especially suited for the position? Do you have any experience, special skills or training that you feel we should be aware of that makes you especially suited for the position? Yes No

Explain:

Are you willing to submit to a drug test? Are you willing to submit to a drug test? Yes No

If hired. would you be able to present evidence of your US citizenship or proof of your legai right to work in the United States? If hired. would you be able to present evidence of your US citizenship or proof of your legai right to work in the United States? Yes No

Are you willing to give us permission to run a criminal background check? Are you willing to give us permission to run a criminal background check? Yes No

Are you willing to give us permission to run DMV check? Are you willing to give us permission to run DMV check? Yes No

Are you currently employed? Are you currently employed? Yes No

Describe your previous and current job roles, including any periods of unemployment (e.g., full-time student, stay-at-home parent, etc.).

Employer's Name:

Supervisor's Name

Address

Zip

City

State

Telephone Number:

Business Type

Employed from

Employed to

Employer's Name

Address

Supervisor's Name

City

Zip

State

Telephone Number:

Business Type

Employed from

Employed to

May we contact this employer?

Name

Address

City

Zip

State

How do you know this person? How do you know this person?Professional colleague or supervisorFriend or personal acquaintanceAcademic or educational connectionOther

Please Specify)

Number of years known

Telephone Number

Name

Address

City

Zip

State

How do you know this person? How do you know this person?Professional colleague or supervisorFriend or personal acquaintanceAcademic or educational connectionOther

Please Specify)

Number of years known

Phone Number

Level Achieved Level Achieved GED High School Diploma College Associate's Degree Bachelor's Degree Others

Please Explain

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. Yes No