Employment

---

Want to join our crew? Just fill out the application below to send us your information and we will contact you.

APPLICANT DATA

Legal Name (Last, First, Middle)


Address


City

State Select a State Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missourri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code

How long at this address?	Home Phone
Cell Phone	Email Address

Have You Ever Worked for the Tire Warehouse?
Yes    No
If Yes, Where and When


Are you 18 Years of age or over?
Yes    No

Have you ever been convicted of any crimes?
Yes    No
If Yes, Explain


Only U.S. citizens or aliens who have a legal right to work and remain permanently in the U.S. are eligible for employment. Can you, after employment, submit verification of your legal right to work in the United States?
Yes    No

Referred to the Tire Warehouse by:


In case of an emergency, notify the following person

Name	Phone Number

POSITION DESIRED

Position for which you are applying:	Salary Expected:
Date available for work:	How many hours per week are you available to work:

With regard to work locations, do you have any geographic preferences or restrictions?
Yes    No
If yes, please specify


All positions at The Tire Warehouse require a valid Drivers License

Has your drivers license ever been suspended or revoked?
Yes    No
If yes, please explain


Do you have a valid drivers license presently?
Yes    No

Do you have a reliable source of transportation (car)?
Yes    No

EMPLOYMENT HISTORY

Have you ever been involuntarily terminated from an employer?
Yes    No

If yes, please explain all occurrences:


PRESENT EMPLOYER

Company name

Type of business

Address


Job Title


Duties & Responsibilities

Date Employed: Start Date	Staring Salary
Present Salary	Immediate Supervisor

Telephone


PAST EMPLOYER 1

Company name

Type of business

Address


Job Title


Duties & Responsibilities


Reason for leaving

Date Employed: Start Date	Date Employed: End Date
Staring Salary	Ending Salary
Immediate Supervisor	Telephone

PAST EMPLOYER 2

Company name

Type of business

Address


Job Title


Duties & Responsibilities


Reason for leaving

Date Employed: Start Date	Date Employed: End Date
Staring Salary	Ending Salary
Immediate Supervisor	Telephone

PAST EMPLOYER 3

Company name

Type of business

Address


Job Title


Duties & Responsibilities


Reason for leaving

Date Employed: Start Date	Date Employed: End Date
Staring Salary	Ending Salary
Immediate Supervisor	Telephone

EDUCATION

High School
School name and location

Last grade/course level completed

Diploma

Major


College
School name and location

Last grade/course level completed

Diploma

Major


Business, vocation training
Name and location

Last grade/course level completed

Diploma

Major


Specialized Skills
Do you have a New York state inspector license?
Yes    No

Do you have any ASE certifications?
Yes    No
If yes, which ASE certifications?


Do you have any tools or tool box?
Yes    No
If yes, what tools & tool box?


Any other special skills?

I CERTIFY THAT THE FACTS SET FORTH IN MY APPLICATION ARE TRUE AND COMPLETE. I UNDERSTAND THAT, IF EMPLOYED, FALSE STATEMENTS OROMISSIONS ON THIS APPLICATION WILL BE GROUNDS FOR IMMEDIATE TERMINATION OF MY EMPLOYMENT. I AUTHORIZE THE TIRE WAREHOUSE TO CHECK ALL PERSONAL AND EMPLOYMENT REFERENCES ANDTO VERIFY ALL INFORMATION I HAVE INCLUDED IN THIS APPLICATION FORM.
I FURTHER UNDERSTAND THAT I HAVE THE OPTION TO TERMINATE MY EMPLOYMENT RELATIONSHIP WITHTHE TIRE WAREHOUSE, WITHOR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE,AT ANY TIME AND THETIRE WAREHOUSE RETAINS THE SAME RIGHTS. I UNDERSTAND THAT IF I AMHIRED, ALL BENEFITS, POLICIES, PRACTICES, AND PROCEDURES MAY BE CHANGED BY THE TIRE WAREHOUSE AT ANY TIME, WITH OR WITHOUT NOTICE. I UNDERSTAND THATTHIS APPLICATION, THE TIRE WAREHOUSE POLICIES, PRACTICES AND PROCEDURES AND ALL OTHER COMMUNICATION DISTRIBUTED TO ME BY THE TIRE WAREHOUSE, WHETHER WRITTENOR VERBAL, BEFORE HIRE OR AFTER I AM EMPLOYED, DOES NOT CONSTITUTE OR SUPLEMENT ANY CONTRACT OF EMPLOYMENT. I FURTHER UNDERSTAND THAT NO AGENT, EMPLOYEE, OR REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO MAKE ANY PROMISES OR AGREEMENTS CONTRARY TO THE FORGOING, UNLESS IT IS INWRITING AND SIGNED BY THE PRESIDENT OFTHE COMPANY.

  By checking this box, I agree to the above terms.