APPLICATION FOR EMPLOYMENT "*" indicates required fields 1PERSONAL INFORMATION2POSITION3MISCELLANEOUS4EDUCATION5EMPLOYMENT HISTORY6REFERENCES7ACKNOWLEDGEMENT AND AUTHORIZATION PERSONAL INFORMATIONName* Date of Birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Address* Are you 18 years of age or older?* Yes No POSITIONPosition Desired Pay Desired Have you ever worked for Gorilla Car Wash? Yes No Why did you leave? Hours Available to work (write the time ranges)Monday Tuesday Wednesday Thursday Friday Saturday Sunday MISCELLANEOUSDo you have a valid driver’s license?* Yes No Do you have your own car?* Yes No Have you ever been convicted of a crime?* Yes No Explain:Are you legally eligible for employment in the United States?* Yes No If selected for employment are you willing to submit to a pre-employment drug-screening test?* Yes No EDUCATIONHigh School - Name/Location High School - Last Year Completed High School - Degree High School - Major or Emphasis College/University - Name/Location College/University - Last Year Completed College/University - Degree College/University - Major or Emphasis Trade School - Name/Location Trade School - Last Year Completed Trade School - Degree Trade School - Major or Emphasis Other - Name/Location Other - Last Year Completed Other - Degree Other - Major or Emphasis EMPLOYMENT HISTORY Row ID Employer Phone Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. REFERENCESList up to four references that are not related to youREFERENCES Row ID Name Title Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. ACKNOWLEDGEMENT AND AUTHORIZATIONI certify that all answers given herein are true and complete to the best of my nowledge I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. Printed Name* Date* MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.