Employment Application
Your name:
Position(s) Applied For:
Desired Pay Rate:
Email Address:
How did you hear about
us?
Street Address:
City
Zip Code
State
Phone #(s)
Drivers
license #
Social Security #
Are you at least 18 years old?
Have you been employed with us before?
Are you currently employed?
If so, may we contact your present
employer?
Are you prevented from becoming employed in
this country because of Visa or Immigration
Status?
Date available for work:
Are you available to work Full Time?
Are you currently on "lay-off" and subject to
recall?
Education
College Graduate?
Other Education or
Military Training?
Work Experience
Start with your present position or most recently
held job.
Address:
Supervisor Name  &  
phone #:
Dates employed/Reason for
Leaving:
Starting/Ending pay rate & work
performed:
Employer:
Address:
Supervisor Name  &  phone
#:
Dates employed & Reason for
Leaving:
Starting/Ending pay rate & work
performed:
Employer:
Address:
Supervisor Name  &  phone
#:
Dates employed & Reason for
Leaving:
Starting/Ending pay rate & work
performed:
Employer:
Address:
Supervisor Name  &  phone
#:
Dates employed/Reason for
Leaving:
Starting/Ending pay rate & work
performed:
Comments: Include explanation of
any gaps in employment.
Comments: Have you been
convicted of a felony or
misdemeanor?
Additional information or other
qualifications that  you would like
for us to consider:
I understand that a criminal
background check may occur as a
condition of this application for
employment:
High School Graduate or GED?
Employer:
Schedule an interview
now:
Tue-Fri 10:00am to
4:00pm
Schedule an interview
now:
Tue-Fri 10:00am to
4:00pm
Schedule an interview
now:
Tue-Fri 10:00am to
4:00pm
Schedule an interview
now:
Tue-Fri 10:00am to
4:00pm
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Employment Application
 
 
 
 
 
Windshield Repair Network
Serving Puget Sound Since 1997
1-866-Ding-Fix