Employee Application Form

Job Application Form

Job application form for Fuel and Tire Savers.

Step 1 of 6

List below your last three employers, starting with the most recent. Please complete all boxes.

Employer #1

Date of Employment under Employer #1(Required)

Leaving Date under Employer #1(Required)

Name of Employer #1(Required)

First Last

Address of Employer #1(Required)

Street Address Address Line 2 City State ZIP Code

Previous Salary under Employer #1(Required)

Job Position Employed under Employer #1(Required)

Previous Supervisor's Name under Employer #1(Required)

First Last

Supervisor's Telephone Number under Employer #1(Required)

Reason for leaving Employer #1(Required)

May we contact employer #1? If not, state brief reason.(Required)

Employer #2

Date of Employment under Employer #2(Required)

Leaving Date under Employer #2(Required)

Name of Employer #2(Required)

First Last

Address of Employer #2(Required)

Street Address Address Line 2 City State ZIP Code

Previous Salary under Employer #2(Required)

Job Position Employed under Employer #2(Required)

Previous Supervisor's Name under Employer #2(Required)

First Last

Supervisor's Telephone Number under Employer #2(Required)

Reason for leaving Employer #2(Required)

May we contact employer #2? If not, state brief reason.(Required)

Employer #3

Date of Employment under Employer #3(Required)

Leaving Date under Employer #3(Required)

Name of Employer #3(Required)

First Last

Address of Employer #3(Required)

Street Address Address Line 2 City State ZIP Code

Previous Salary under Employer #3(Required)

Job Position Employed under Employer #3(Required)

Previous Supervisor's Name under Employer #3(Required)

First Last

Supervisor's Telephone Number under Employer #3(Required)

Reason for leaving Employer #3(Required)

May we contact this employer #3? If not, state brief reason.(Required)

References

Give the name of three persons NOT RELATED TO YOU whom you have known at least one year.

Reference #1

Name of Reference #1(Required)

First Last

Reference #1 Phone Number(Required)

Reference #1 Address(Required)

Street Address Address Line 2 City State ZIP Code

Reference #1's Business(Required)

Years Acquainted with Reference #1(Required)

Reference #2

Name of Reference #2(Required)

First Last

Reference #2 Phone Number(Required)

Reference #2 Address(Required)

Street Address Address Line 2 City State ZIP Code

Reference #2's Business(Required)

Years Acquainted with Reference #2(Required)

Reference #3

Name of Reference #3(Required)

First Last

Reference #3 Phone Number(Required)

Reference #3 Address(Required)

Street Address Address Line 2 City State ZIP Code

Reference #3's Business(Required)

Years Acquainted with Reference #3(Required)

If you are applying for a position that requires driving, please complete this section:

Do you have a valid driver's license?(Required)

License #(Required)

Please enter your license number.

State(Required)

Please enter the state in which your driver's license is valid in.

Note: If you are selected for an interview, you are required to present a copy of your driving record that is not more than 4 weeks old. After being hired, a copy of this driving record will be placed into your personnel file and an annual update will be required.

False information given or implied on an application form is grounds for immediate dismissal without further notice.

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, I agree that I may be discharged if Fuel & Tire Saver Systems Company, LLC. at any time learns of falsification or material omission in the information provided on this application form and related documents. I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either m or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.

Fuel & Tire Saver Systems Company, LLC. may contact my former employers in connection with the consideration of my employment with them. All references are hereby authorized to release all information that they may have relevant to my employment with them. I hereby release Fuel & Tire Saver Systems Company, LLC., its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references.

In consideration of my employment, I agree that I will follow all Company policies, rules, procedures, and all other directions pertaining to my employment. I understand that Fuel & Tire Saver Systems Company, LLC. reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at any time.

No Company representative, other than its President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

Applicant Name

First Last

Date of Signature

NO CONSIDERATION OF EMPLOYMENT WILL BE GIVEN TO ANY APPLICANT WHO DOES NOT SIGN THE ABOVE STATEMENT.

Note: Additional personal information will be required after being hired.
Thank you for showing an interest in pursuing a career with Fuel & Tire Saver Systems Company, LLC/

Job Application Form

Educational Background

General

Employer #1

Employer #2

Employer #3

References

Reference #1

Reference #2

Reference #3

If you are applying for a position that requires driving, please complete this section:

False information given or implied on an application form is grounds for immediate dismissal without further notice.

NO CONSIDERATION OF EMPLOYMENT WILL BE GIVEN TO ANY APPLICANT WHO DOES NOT SIGN THE ABOVE STATEMENT.

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