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Date

First Name:

Last Name:

Address:

Address Line 2:

City:

State / Province

ZIP / Postal Code

Phone:

Are you 18 years or older?

Yes

Have you ever been convicted of a crime?*

Yes

If Yes, gives details, including dates*

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*A “yes” answer will not automatically disqualify you from employment. We will consider the nature and date of the offense and the job for which you are applying for job-related purposes only, and only to the extent permitted by applicable law.

Work Experience*

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Please list all previous employment, beginning with the most recent. Please include military service as work experience. Please include the following information for EACH employer: Employer Name, Address, Phone Number, Dates of employment, Position, Reason for leaving

References

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Please provide THREE persons not related to you.

I certify that the foregoing statements are true and correct. I authorize Auto Trim Design to make investigation of my personal or employment history and authorize any present/former employer, person, firm, corporation, credit agency or government agency to give Auto Trim Design any information they may have regarding me, and I understand that any misrepresentation, or omission shall be cause for dismissal. In consideration of the prospective employer review of this application, I release Auto Trim Design and all providers of information from any liability as a result of furnishing and receiving this information. I further agree that, if employed, I will conform my conduct to Auto Trim Design’s rules, regulations and personnel policies. I understand that no personnel recruiter, interviewer or other representative other than an officer of Auto Trim Design has authority to enter into any agreement for employment for any specified period of time and that any employment manuals or handbooks that may be distributed to me during the course of my employment shall not be construed as a contract. I further understand that nothing contained in this application or the granting of an interview creates a contract for either employment or providing any benefit, and THAT I HAVE THE RIGHT TO TERMINATE EMPLOYMENT AT ANY TIME AND THAT AUTO TRIM DESIGN HAS THE SAME RIGHT.

I agree

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