General Information
First
Name:
Last
Name:
Address:
City:
State:
(Choose State)
MD
VA
DC
WV
Zip
Code:
Telephone
number:
Email
Address:
Desired
Position:
(Pick One)
Manager
Assistant Manager
Technician
Customer
Service Adv
Are
You Legally Entitled To Work In the US?
YES
NO
If
no, please explain
Do
You Currently Have A Valid Driver's License?
YES
NO
Have
You Previously Worked For Jiffy Lube?
YES
NO
If
yes, please explain
Are
You Currently Employed?
YES
NO
If
yes, please explain
Education
Choose
Highest Grade Completed
(Pick One)
6
7
8
9
10
11
12
College(1)
College(2)
College(3)
College(4)
Grad(1)
Grad(2)
Grad(3)
Grad(4)
Other(1)
Other(2)
High
School (Name,City,State)
Degree?
YES NO
College
Name (Name,City,State)
Degree? YES NO
Vocational(Name,City,State)
Degree? YES NO
Other(Name,City,State)
Degree? YES NO
Explain
Other
Technical Skills/Experience (Please
explain any additional skills you may have)
Automotive
Training
Management
Training
Other
Training Or Skills (Please Describe)
Work Experience (Please
fill in the last three jobs you have had)
JOB
#1
Company Name:
Address:
Dates Employed (mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and
Description (Give
full descriptions of duties, responsibilities and equipment used)
JOB
#2
Company
Name:
Address:
Dates Employed(mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and
Description (Give
full descriptions of duties, responsibilities and equipment used)
JOB
#3
Company Name:
Address:
Dates Employed (mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and
Description (Give
full descriptions of duties, responsibilities and equipment used)
Additional Information
Location Preference:
Minimum Wage/Salary Requirements:
Date Available To Start:
Are
You Willing To Work Overtime And Weekends?
YES
NO
If
No, Why Not?
