Employment Application

Personal Information:

First, Last Name:

Address:

Phone:

Position Sought:

When are you available to start?

Work History:

Current/Most Recent Employer:
Name:

Address:

Phone:

Previous Supervisor:

May We Contact? Yes No
Final/Current Salary/Wage:
$
Responsibilities:

Dates Employed:

Next Most Recent Employer:
Name:

Address:

Phone:

Previous Supervisor:

May We Contact? Yes No
Final Salary/Wage:
$
Responsibilities:

Dates Employed:

References:

Name:

Address:

Phone:

Relationship:

Education:

Highest Level completed:
Post-Graduate (M.S., M.A., M.B.A., Ph.D)
College (B.S., B.A.)
Technical (Associates)
High School/GED

Status:

I am a U.S. veteran: Yes No
I am legally authorized to work in the United States, and can furnish documentation:
Yes No
I am 18 years of age or older: Yes No
I have been convicted of a felony: Yes No
If yes, please explain:

Verification:

I certify that the information entered above is true and correct to the best of my knowledge. I authorize Thunder Basin Ford, LLC to contact any and all references listed above. I understand that Thunder Basin Ford, LLC may make inquiries through a third party in order to verify statements on this application. I understand that falsification of information on this form constitute grounds for immediate dismissal. I understand that this application does not constitute an offer of employment. I understand that, as a condition of employment, I may be required to pass a drug test.

Electronic Signature:

My initials entered in the box below constitute my signature confirming the accuracy of all information provided as well as my permission for Thunder Basin Ford, LLC to verify the information provided.

Initials