Join Our Team! Application for Employment THIS FORM HAS BEEN DESIGNED TO STRICTLY COMPLY WITH STATE AND FEDERAL FAIR EMPLOYMENT PRACTICE LAWS PROHIBITING DISCRIMINATION. ALL QUALIFIED APPLICANTS WILL RECEIVE EQUAL CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, NATIONAL ORIGIN, AGE, MILITARY BACKGROUND, HANDICAP, MARITAL STATUS, HEIGHT, WEIGHT, OR ARREST RECORD. Name First Last Home Telephone NumberPresent Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Previous Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP In case of Emergency NotifyNameAddressTelephone No.Position DesiredFull Time / Part Time Full Time Part Time Wages DesiredDate you can start work How did you learn about this job?Ever applied to this Company before? Yes No What department?When?If related to anyone in our employ, give name and relationshipAre you a citizen of the U.S.? Yes No If no, do you have a permit which allows you to work in the U.S.?Do you have a valid operator's permit? Yes No Do you own a car? Yes No StateDriver's License NumberHas your operator's permit ever been suspended, revoked or restricted? Yes No If yes, when & why?Have you been in an auto accident in the past three years? Yes No Have you ever been refused surety bond? Yes No If yes, when & why?Have you ever been convicted of a crime? Yes No If yes, describe in fullHave you ever been discharged or required to resign from a position? Yes No Are you on a lay-off and subject to recall? Yes No Work time lost last year due to tardiness or absenteeismHoursDaysBranch of Service, if anyRankHigh School or Prep School (Name and Location)Major SubjectNo. of YearsDegreeUniversity or CollegeMajor SubjectNo. of YearsDegreeGraduate SchoolMajor SubjectNo. of YearsDegreeOTHER - Including Military Service, Trade or Business SchoolsMajor SubjectNo. of YearsDegreeExperience - Business or Professional Record of Last Five Positions(List Places in Order starting with Present Employer First)Work Experience (Used the (+) icon to add another employer)Name and Address of EmployerPosition or TitleSupervisor's NameSalary ReceivedReason for SeparationFrom (Months/Year)To (Months/Year) Have you previously signed a non-disclosure or non-compete agreement with your current employer or any past employer?YesNoIf yes, explain:Please read carefullyApplicant's Certification, Authorization, and Acknowledgement I certify that the facts set forth in this employment application are true nad complete to the best of my knowledge. I understand that if employed , false statements on this application may subject me to dismissal. You are authorized to make an investigation of my employment history and my personal history through nay investigative agencies or bureaus of your choice, and to contact my current and any of my former employers and I give such employers to the right to release to you all records of my employment (excluding medical records) including assessment of my job performance and ability. I understand that you may require a motor vehicle record report and authorize you to obtain said report. I understand that you reserve the right to require that an offer of employment is conditional upon the results of a medical examination including but not limited to any drug screening tests. I understand that you reserve the right to require drug screening tests at any time during employment. If employed, I understand that if I need an accommodation for a handicap under the Michigan Handicappers Civil Rights Act (Act), I must notify the dealer in writing of my need for an accommodation within 182 days after I know or should have known that I need that accommodation and my failure to provide that notice will prevent me from claiming that my employer failed to accommodate my handicap under the Act. This requirement does not waive an individual's rights under the Americans With Disabilities Act. I further understand that the use of this form does not indicate that there are any positions open and does not in any way obligate this dealership. This Application is current for ninety (90) days. At the conclusion of this time, if I have not been employed by this dealership and still wish to be considered for employment, it will be necessary for me to fill out a new Application. Further, I understand and agree that if I am hired by this dealership, unless specifically set forth in writing to the contrary and signed by the dealer and myself, my employment will be for no definite period, and may, regardless of the date of payment of my wages or salary, be terminated at any time for reason or no reason at the will of the dealership without any previous notice. THE INFORMATION ON THIS APPLICATION IS SUBJECT TO VERIFICATION. FALSIFICATIONS OR MISREPRESENTATIONS MAY DISQUALIFY YOU FROM CONSIDERATION FOR EMPLOYMENT OR, IF HIRED, MAY BE GROUNDS FOR TERMINATION AT A LATER DATE. BY CLICKING SUBMIT, I CERTIFY THAT ALL INFORMATION ON THIS APPLICATION IS TRUE, CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE ALL FORMER EMPLOYERS TO RELEASE JOB RELATED INFORMATION ABOUT ME AND I RELEASE ALL PERSONS OR COMPANIES FROM ANY LIABILITY FOR PROVIDING SUCH INFORMATION. I UNDERSTAND THAT ALL APPLICATIONS BECOME PROPERTY OF THE DAN PFEIFFER AUTOMOTIVE GROUP.CommentsThis field is for validation purposes and should be left unchanged.