Join our team at Harr Collision Center

How were you referred to us?*

Name*

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Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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18 Years Or Older*

Income Expectations Annually*

Date You Can Start*

Have you worked here before

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If YES, When*

Are you a citizen of the United States?

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If NO, are you legally allowed?

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Type of employment desired

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Part-Time
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Ever been convicted of a Felony?

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No

If YES, give dates/details*

Answering "yes" to this questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

Summarize Your Special Skills or Qualifications

Previous Employment Details

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Previous Employment 2
Previous Employment 3

Dates of Employment

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Start Annual Income & Title

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Reason for Leaving

May we contact this employer for reference ?

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Dates of Employment

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Date

To

Positions(s) Held

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Address of Employer

Company Phone Number

Supervisor

Title of Supervisor

Your Responsibilities

Start Annual Income & Title

End Annual Income and Title

Reason for Leaving

May we contact this employer for reference ?

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Dates of Employment

From

Date

To

Positions(s) Held

Firm / Company

Address of Employer

Company Phone Number

Supervisor

Title of Supervisor

Your Responsibilities

Start Annual Income & Title

End Annual Income and Title

Reason for Leaving

May we contact this employer for reference ?

Yes
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AUTHORIZATION

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information giving in my application or interviews(s) may result in discharge.

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