Office Job Application form

Front Desk and/or Dispatcher Job App - (If you want to apply for a tow truck driver position, please CLICK HERE)

Front Desk and/or Dispatcher Job App

Full Name *

First Name Middle Initial Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

E-mail *

Phone Number *

Area Code Phone Number

Available start date: *

Month Day Year

Do you have a valid driver's license?

Yes No

Are you authorized to work and remain in the United States?

Yes No

Were you ever discharged or forced to resign from any position?

Yes No

If Yes, Explain:

Have you ever been employed by Henry's?

Yes No

Position:

Department:

Are you related to any Henry's employee?

Yes No

Name of Employee:

Relationship:

Department:

Have you served in the U.S. Armed Forces?

Yes No

If Yes, Branch:

Date Entered Active Duty:

Month Day Year

Date Released Active Duty:

Month Day Year

Have you ever been convicted of any violation of the law? (Exclude traffic violations) A conviction will not necessarily disqualify an applicant from the position sought.

Yes No

If Yes, Explain:

Are you a High School Graduate?

Yes No

High School Equivalency?

Yes No N/A

Are you presently attending school?

Yes No

Type of Education

Name of Instiution

Field of Study

Type of Degree

Did you Graduate?

Yes No

Do you have additional education to enter?

Yes No

Additional Type of Education

Name of Instiution

Field of Study

Type of Degree

Did you Graduate?

Yes No

Type

Serial Number

Date Issued

Expiration Date

Month Day Year

Word Processing:

Yes No

List Computer Background and Years of Experience:

Name of Employer:

Job Title:

Phone Number

Area Code Phone Number

Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Supervisor:

Ending Salary Per Month:

Date started

Month Day Year

Date ended

Month Day Year

Reason for Leaving:

Description of Duties:

Do you have additional employers to enter?

Yes No

Name of Employer:

Job Title:

Phone Number

Area Code Phone Number

Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Supervisor:

Ending Salary Per Month:

Date started

Month Day Year

Date ended

Month Day Year

Reason for Leaving:

Description of Duties:

Inquiry may be made of your current and former employers/schools you attended.

May we contact your present employer?

Yes No

May we contact your former employers?

Yes No

Full Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Click to edit

Business or Occupation

Phone Number

Area Code Phone Number

APPLICANT’S STATEMENT AND AUTHORITY TO RELEASE INFORMATION

(Required for ALL Positions)

I understand that this employment application and any other documents are not contracts of employment, and any person hired may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not be relied upon by a prospective or existing employee. I understand that Henry's Wrecker Service, Inc (Henry's) may modify, change, or revoke any of its employment policies, pay practices, and benefits without my agreement. I hereby state that all answers on this application are true and understand that falsifying this information can lead to termination if hired. I UNDERSTAND THAT IN ACCORDANCE WITH POLICY, FINAL CANDIDATES ARE SUBJECT TO AN ALCOHOL / DRUG TEST AS A CONDITION OF EMPLOYMENT.

I hereby authorize any and all persons, companies, or agencies to release any and all background information, of a confidential or privileged nature, including criminal history, relevant to this application and any pertinent information they may have to the hiring authorities of Henry's.

I release all such parties from all liability of every kind as the result of furnishing the same to Henry's. This information is to be used to assist Henry's in determining my qualifications and fitness for the position I am seeking. I hereby release Henry's and its officers, agents and employees from any liability for the use of any and all of the foregoing information, in consideration for being reviewed for the aforesaid position.

I certify that I have read and agree to the above RELEASE. *

I AGREE

Full Name

Phone Number

Area Code Phone Number

Date

Month Day Year

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

The following information we are soliciting is strictly voluntary. This form will be kept separate and confidential from the application.

Information provided on this form will not be considered in any employment decision but is for statistical purposes only.

How did you learn about this position?

Employment Service School Newspaper Internet Career Fair Walk-In

Upload File

Application for Employment

Education:

Professional License or Certificate, If Required

Skills

Employment History

Personal References

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