Employment Application
TRIPLE A SERVICES, INC.
APPLICATION FOR EMPLOYMENT
Position Applied For: Wage Requested:

Drivers License Number Date Of Application

First Name Middle Last Name
Address Apt./P.O. Box
City State Zip Code
Telephone Social Security Number


EMPLOYMENT HISTORY (List your last four employers, assignments or volunteers, starting with the most recent)
Employer Name May we contact them Yes No
Address City
State Zip Code

Employed From: To: Job Title
Telephone Immediate Supervisor & Title
Job Duties
Reason for Leaving

Starting Pay per
Final Pay per

Employer Name May we contact them Yes No
Address City
State Zip Code

Employed From: To: Job Title
Telephone Immediate Supervisor & Title
Job Duties
Reason for Leaving

Starting Pay per
Final Pay per

Employer Name May we contact them Yes No
Address City
State Zip Code

Employed From: To: Job Title
Telephone Immediate Supervisor & Title
Job Duties
Reason for Leaving

Starting Pay per
Final Pay per

Employer Name May we contact them Yes No
Address City
State Zip Code

Employed From: To: Job Title
Telephone Immediate Supervisor & Title
Job Duties
Reason for Leaving

Starting Pay per
Final Pay per

If you are under 18, can you furnish a work permit? Yes No
Have you ever been employed by Triple A Services, Inc.? Yes No

Were you referred by an Employee of Triple A Services, Inc.? Yes No
If Yes, Name of Employee

Have you applied to Triple A Services, Inc. in the past? Yes No
If yes, please supply Date:

Are you legally eligible for employment in this country?
(Proof of US citizenship or immigration status will be required upon employment)		 Yes No

Type of employment desired: Full-time Part-time Temporary
Date available for work:

Have You been convicted of a felony in the last seven years?
(Such conviction may be relevant if job-related, but does not bar you from employment)		 Yes No
If yes, please explain:



SKILLS AND QUALIFICATIONS
Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work for Triple A Services, Inc.

EDUCATIONAL BACKGROUND
High School
Name and Location Years Completed
Did You Graduate Yes No Course Of Study

College
Name and Location Years Completed
Did You Graduate Yes No Course Of Study

Other:
Name and Location Years Completed
Did You Graduate Yes No Course Of Study

REFERENCES
Name Telephone Years Known
Name Telephone Years Known
Name Telephone Years Known
Please understand this application is for review only and a Triple A Services, Inc. application will need to be filled out prior to any consideration of employment.

Prior to employment, if you are selected, you will receive, read, and understand Triple A Services, Inc. employee handbook and sign a accompanying form.

It is understood and agreed that any misrepresentation by yourself in this application and any others will be sufficient cause for cancellation of this application and any others and/ or separation from the employer's service if you have been employed. Furthermore, you understand that just as you are free to resign at any time, Triple A Services, Inc. reserves the right to terminate your employment at any time with or without cause and without prior notice. You also understand that no representative of Triple A Services, Inc. has the authority to make any assurances to the contrary.

You also give Triple A Services, Inc. the right to investigate all references and to secure additional information about yourself, if job related. By submitting this application information you hereby release from liability Triple A Service, Inc. and it's representatives for seeking such information and all other person's, corporations, or organizations for furnishing such information.

Triple A Services, Inc. is an Equal Opportunity Employer

Triple A Services, Inc. Company Logo
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