EMPLOYMENT APPLICATION

This form has multiple sections, please fill it out in its entirety.

Thank you for your interest in applying for a job with Herb Connolly. Because of our commitment to offering the highest possible satisfaction to our customers, we are only interested in hiring the best. We want to have a complete understanding of your qualifications, motivations and interests, so that we can make careful and deliberate hiring decisions that will benefit both our Dealership and our employees. Please answer the following questions honestly, completely, and thoughtfully.

We are an Equal Opportunity Employer and do not discriminate on the basis of race, color, religion, sex, national origin, age, marital status, military status, veteran status, handicap, disability or other legally protected classifications.

Contact Information
Your Name:
Internet E-Mail:

 
Home Phone:
Business Phone:
Address:
 
City:
State:
Zip:

Soc. Security #:

Are you at least 18 years of age?    Yes:   No:
If you are under 18 years of age, do you have a work permit?    Yes:    No:
Position Information
Position you are interested in:
Are you interested in: Full Time: Part Time: Temporary:
What days and hours are you available?
What pay do you expect?
When can you start work?
Current Status Information
Have you ever applied for employment with us?    Yes:    No:
If so, what position and what dates?
Do you have any relatives currently working with us?    Yes:   No:
If yes, please list their names: Employee1:
  Employee2:
  Employee3:
Education Information
Did you graduate high school?    Yes:   No:
Did you graduate college?    Yes:   No:
If so, what college?
If you didn't graduate college, how many years did you attend?
1 Year: 2 Years:
3 Years: 4 Years:
More than 4 Years:  
Did you attend a technical college?    Yes:   No:
If so, what school?
Please list any licenses or certificates that would relate to this job: License1:
  License2:
  License3:
List skills or equipment you can operate relative to the job you are applying for: Skills1:
  Skills2:
  Skills3:
Have you ever been in the U.S. Armed Forces?    Yes:   No:
If so, which branch?
References
Have you ever been fired from a job or asked to resign?    Yes:   No:
If yes, please explain:
Have you ever worked or attended school under another name?    Yes:   No:
If yes, please list:
Have you ever been convicted of any law violation (except a minor traffic violation)?    Yes:   No:
If yes, please list incident, city, state and charge below:
(Conviction will not necessarily disqualify an applicant for employment.):
Can you, if employed, submit verification of your right to work in the United States?    Yes:   No:
Reference 1 (optional)
Name:
Occupation:
Address:
Phone:
Relationship (do not list relatives) :
Reference 2 (optional)
Name:
Occupation:
Address:
Phone:
Relationship (do not list relatives):
Reference 3 (optional)
Name:
Occupation:
Address:
Phone:
Relationship (do not list relatives):
Employment History - Position 1
List Present and Past Employers, MOST RECENT FIRST.
Employer:
Address:
 
Phone:
Kind of Business:
Start Date:
Termination Date:
Are you currently working for this employer?    Yes:   No:
If yes, may we contact this employer?    Yes:   No:
Supervisor:
Starting Salary/Wage:
Ending Salary/Wage:
Salary/Wage rate per:
Hour: Week: Month: Year:
Duties:
Reason for leaving:
Additional Comments:
Employment History - Position 2
Employer:
Address:
 
Phone:
Kind of Business:
Start Date:
Termination Date:
Supervisor:
Starting Salary:
Ending Salary:
Salary/Wage rate per:
Hour: Week: Month: Year:
Duties:
Reason for leaving:
Additional Comments:
Employment History - Position 3
Employer:
Address:
 
Phone:
Kind of Business:
Start Date:
Termination Date:
Supervisor:
Starting Salary:
Ending Salary:
Salary/Wage rate per:
Hour: Week: Month: Year:
Duties:
Reason for leaving:
Additional Comments:
Experience
Service Department

Office Manager
Sales Department

New Car Sales Manager



Parts Department

Parts Manager


Motor Vehicle Information
Please complete this section if the job for which you are applying might require you to drive company vehicles.

Do you have a valid drivers license?:

Yes No

License number and state :

Have you had any accidents in the last 5 years?:

Yes No

If yes, please give details:

Have you been cited for any moving violations in the last five years?:

Yes No

If yes, please give details:

Has your drivers license ever been suspended, revoked, denied or canceled?:

Yes No

If yes, please give details:

By submitting this application, I certify that I have read, understand and agree to each of the following statements:

All of the information I have supplied on this application is true, accurate and complete, to the best of my knowledge, and I have not knowingly withheld any information which, if known to Herb Connolly, would affect my application unfavorably. If I am hired by Herb Connolly and if Herb Connolly discovers at any time during my employment that any of the statements or answers on this application are false, misleading, or incomplete, I may bedismissed immediately from my job. I agree to submit to a medical examination, which may include testing for drugs or alcohol prior to beginning work for Herb Connolly. If I am extended an offer or employment, I agree to submit to a medical examination, which may include testing for drugs or alcohol prior to beginning work with Herb Connolly, and I understand that any offer of employment is conditioned upon passing such medical examination. I further understand that I may be required to submit for a test for the use of illegal drugs at anytime. I understand that nothing in this employment application creates a contract of employment betweenHerb Connolly and me. If I am hired by Herb Connolly, my employment and compensation are “at will” which means that myemployment can be terminated, either by Herb Connolly or me, with or without cause, and with or without notice. I understand that no manager or supervisor has the authority to make any employment agreement with me, either orally or in writing that is not an at-will agreement. Only the Owner(s) of Herb Connolly has the authority to enter into an employment agreement with me for any specified period of time.

I agree to release to Herb Connolly or its designated representatives all medical information, including but not limited to, files, reports, x-rays, evaluations, and opinions held by medical personnel, to the extent such information is job related and consistent with business needs. I acknowledge that this is a general release and that if hired, it remains in effect for the duration of my employment.

I authorize Herb Connolly to conduct any investigation regarding the information contained in my employment application which Herb Connolly thinks is necessary to determine my qualifications for assuming a job with Herb Connolly. I give Herb Connolly or its designated representatives my permission to contact any former employer, school, college or university, utility dealership, credit or finance bureau or office, any personal or professional reference, or any other appropriate source or individual for the purpose of gathering any information, personal otherwise, that such sources may have about my character, general reputation, credit, education, or employment record. I hereby give my consent to any such sources to release to Herb Connolly whatever information they have about me. I also unconditionally release all named and unnamed sources from any and all liability, which might result from furnishing any information about me. Upon written request, additional information as to the nature and scope of any credit report, if one is made, will be provided. Herb Connolly will comply with the Fair Credit Reporting Act requirements in conducting any background checks.

In the event of my personal indebtedness to Herb Connolly, I authorize Herb Connolly to withhold from my wages suchamounts as permitted by law to satisfy my obligation to Herb Connolly.

This employment application will be considered active for sixty (60) days from the date below. If I want to be considered for a job with Herb Connolly after this period of time, I must fill out another application.

I understand and agree that compliance with all Herb Connolly rules and regulations is a condition of employment with Herb Connolly.