Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
Position Applying For
*
Customer Care Coordinator
If the position requires, are you willing to travel?
*
Are you legally eligible for employment in the U.S.?
*
Are you over the age of 16?
*
Social Security Number
*
Driver's License Number
*
Date Available for Employment
*
MM
DD
YYYY
Do you have any objection to working overtime if necessary?
*
Have you previously been employed by Pittsburgh Auto Group or affiliates?
*
If Yes, Provide Dates of Previous Employment:
Have you ever been convicted of a crime other than a minor traffic offense?
*
If Yes, please explain the date, nature of crime, whether or not you were incarcerated and if so, when did your incarceration begin and how long did it last; your present status, and any other information you would like us to consider when evaluating your response.
Note: A criminal conviction will not necessarily disqualify you for employment. Related factors such as age and date of conviction, seriousness and nature of crime, and rehabilitation will be considered.
Name & Address of High School
*
Number of Years Completed
Graduated
*
Name & Address of College/Trade School
Number of Years Completed
Graduated
Describe any education courses or programs you are currently enrolled in.
Please also indicate the target date for completion.
Most Recent Employer
Please list the name and address of your most recent employer. Please also include the dates of employment.
Job Duties
Please list your job duties and titles from your most recent employer.
Supervisor Contact
Please list the number of your supervisor at your most recent employer.
(###)
###
####
May we contact this employer?
Reason for Leaving
Previous Employer
Please list the name and address of your previous employer. Please also include the dates of employment.
Job Duties
Please list your job duties and titles from previous employer.
Supervisor Contact
Please list the number of your supervisor at your previous employer.
(###)
###
####
May we contact this employer?
Reason for Leaving
Previous Employer
Please list the name and address of your previous employer. Please also include the dates of employment.
Job Duties
Please list your job duties and titles from previous employer.
Supervisor Contact
Please list the number of your supervisor at your previous employer.
(###)
###
####
May we contact this employer?
Reason for Leaving
Please explain why you are interested in working for Monroeville BDC.
*
Are there any other experiences, skills or qualifications which you feel would qualify you to work at Monroeville BDC?
Ex. Sales Experience, Technician Certifications, Computer Skills, etc.
Professional Reference
*
Please provide the name of a professional reference. Please do not include a relative.
First Name
Last Name
Relationship
*
Company
*
Phone Number
*
(###)
###
####
Email
*
Years Known
*
Professional Reference
*
Please provide the name of a professional reference. Please do not include a relative.
First Name
Last Name
Relationship
*
Company
*
Phone Number
*
(###)
###
####
Email
*
Years Known
*
Personal Reference
*
Please provide the name of a personal reference. Please do not include a relative.
First Name
Last Name
Phone Number
*
(###)
###
####
Email
*
Years Known
*
Signature of Applicant
*
I certify that the information set forth in the attached Application for Employment is true and compete to the best of my knowledge, and I authorize Monroeville BDC to verify its accuracy and to obtain reference information on my education, background and work performance. I hereby authorize my previous employers (as indicated), educational institutions and references to release such information as may be requested by Monroeville BDC, and I release them from any and all liability, claims or damages that may result from the use, disclosure or release of any such information. I also release Monroeville BDC from any and all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that any false statements, omissions, or misrepresentations made in this application may be grounds for rejecting my employment application, and if I am employed by Monroeville BDC, termination of my employment from Monroeville BDC
I authorize that Monroeville BDC may conduct criminal and driving record checks. Following an offer of employment, and, where appropriate as a continuing condition of employment should I be hired, Monroeville BDC may require that I submit to a medical examination. Monroeville BDC also reserves the right to require me to undergo drug testing prior to employment or at any time during my employment, to the extent permitted by law.
I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal authorization to work in the United States within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.
I agree that if an employment offer is extended to me and accepted, I will comply with all of Monroeville BDC's policies, rules and regulations. However, I understand that neither the policies, rules, regulations nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and is at will. I further understand that I or Monroeville BDC may terminate my employment at any time with or without prior notice, and for any reason not prohibited by law. If I become employed by the Company, I agree that in consideration of my employment I will not commence any suit which relates in any way to my employment and/or termination of my employment which would otherwise be timely, after the statute of limitations has expired or more than six (6) months after the date of the event giving me a right to relief, whichever is shorter, regardless of the circumstances of the event or termination, and I waive any longer statute of limitations to the contrary.
I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.
Date
*
MM
DD
YYYY