PERSONAL

 First Name   Middle   Last

 Street Address   City   State    

 Zip   Home Phone  Work Phone:         

 Your email address:

 Cell Phone:      Other Phone (Optional):

  Yes, Please discreetly contact me at work.     

  No, Please do not contact me at work, use my other contact information.

 How did you hear about this OPPORTUNITY? Choose One Radio Television Newspaper SW Bell Yellow Pages FEIST Yellow Pages Internet Friend/Relative/Co-Worker Bigham Automotive Employee Other  

 If hired, do you have a reliable means of transportation to get to work?  Yes   No

 Do you have a valid driver's license  Yes   No

 Minimum salary expected (required)     Please choose One Yearly Monthly Weekly

 Are you at least 18 years or older?    Please choose One YES NO

  Are you legally eligible for employment in the U.S.?  Yes  No
  (Must have proof of immigration status if hired)

 Have you been convicted of a crime? Please choose One YES NO   (If yes, state the nature of the offense and disposition of the case. Include dates and places. NOTE: The existence of a criminal record does not constitute an automatic bar to employment.)
 

 EMPLOYMENT DATA

 Are you seeking:  Temporary   Full-time  Part-Time             

What position are you applying for (Check all that apply)?

     ADMINISTRATION 			    PARTS DEPARTMENT

General Manager			Parts Dept. Manager  

Operations Manager			General Parts Counterperson  

Service Contracts & Finance		Outside Sales

Accounting/Bookkeeping		Wholesale Sales

Marketing/Advertising			Transmission Parts Counter

Outside Sales/Fleet Mgmt./New Accounts

Customer Care/Relations

  SERVICE DEPARTMENT			       COLLISION DEPARTMENT

Service Manager			Collision Dept. Manager 	      

Service Advisor/Writer		Body Repair Technician

Shop Foreman				Detail Technician

General Repair Technician		Painter	   

Diagnostic Technician

Alignment/Front-end Technician

Heavy Line/Chassis Technician			                  

  TRANSMISSION DEPARTMENT

Transmission Builder

Transmission R&R

Swingman

 Are you willing to work overtime?  Yes  No           Weekends?  Yes  No
 Holidays? Yes  No

 Are you currently employed?  Yes  No

 If hired, when would you be able to start?

 Have you ever worked for this organization before?   Yes   No  

 If yes, name used:

 List any friends or relatives employed by this company: 

 Are you on layoff and subject to recall?  Yes  No

 Have you ever been discharged or asked to resign from any position?   Yes     No     

 If yes, please describe: 
 

 How many days have you missed from school or work within the last year other than approved vacation,  sick, or disability leave?    

 How may days have you been late to school or work within the last year other than approved vacation, sick, or disability leave?    

 EDUCATION (Circle highest grade attained)

 ELEMENTARY  Choose the highest Elementary Grade Achieved 1 2 3 4 5 6    

 Name of School 

 Location of School (City & State) 

 SECONDARY (Junior High/ High School) Choose highest level of Secondary School 0 7 8 9 10 11 12 G.E.D.

  Name of School 

  Location of School (City & State)

 
 COLLEGE  Choose the highest level of College 0 1 2 3 4 5 6 7 8 Graduate Degree Obtained Doctoral Degree Obtained  
 
 Name of School 

 Location of School (City & State)

 Degree and Major:         Minor:  

 If currently in high school, are you enrolled in a recognized co-op program?  Yes   No

 If yes, identify program and school:  

  MILITARY SERVICE

  Are you a veteran? Yes No
  If yes, give dates of service:  From to

 List any special skills or training:   

 WORK HISTORY (start with the most recent)

 1. Company 
     Phone no. w/ area code 
     Address   
     City/State/zip 
     Dates of Employment: From       To     
     Salary Beginning From        Ending  
     Supervisor's name & Title        
 Describe duties briefly:          
   Specific Reason for Leaving:

 2. Company 
     Phone no. w/ area code 
     Address   
     City/State/zip 
     Dates of Employment: From       To     
     Salary Beginning From       Ending  
     Supervisor's name & Title        
 Describe duties briefly:          
   Specific Reason for Leaving:

   3. Company    
       Phone no. w/ area code 
       Address   
       City/State/zip 
       Dates of Employment: From   To     
       Salary Beginning From       Ending  
       Supervisor's name & Title        
 Describe duties briefly:          
   Specific Reason for Leaving:

    3. Company    
        Phone no. w/ area code 
        Address            
        City/State/zip 
        Dates of Employment: From       To     
        Salary Beginning: From    Ending  
        Supervisor's name & Title        
   Describe duties briefly:          
   Specific Reason for Leaving:

 May we contact all of the employers listed above?  Yes   No    If not, tell us which one(s) you do not wish us to contact and why.

 How may jobs have you had in the last five years not listed above? Choose 0 1 2 3 4 5 6 7 8 9 10

 Why are you seeking a new position at this time? 

 List any business-related outside interests and organizations you're active in:

  My current or most recent salary was based on:

        Salary        Base + Commission              Flag Hour

        Other          Sales Commissions only       Bonus

4.  Please check the benefits paid or offered to you by your employer (or your previous employer):

    Holidays          Health Care    Uniforms               401K

    Vacation          Bonuses          Life Insurance     Retirement

    Stock Opts      Child Care       Comp. Car            Dental

    Eye Care          Fuel Allowance

5.  Fill in all that apply to you.

     I have been an automotive technician for years.

     I have been a manager, (any type of manager), for years.

     All of my combined automotive experience totals years.

6.  If you are currently working for an automotive business, what type of business?

    New Car Dealer          Independent Shop        Chain/Franchise Store

7.  Are you an A.S.E. Master Technician    Yes     No

     If yes, when do your Certifications expire?

8.  I have A.S.E. CERTIFICATIONS in the following areas:

Automatic Transmissions Major Engine Repair Manual Transmissions Front End Alignment Air Conditioning Brakes Tune-up/Performance Electrical Differentials Fuel Injection

 Engine Performance          Body Repair

 Plastics	                Painting

 Parts

9.  I have have/had Factory CERTIFICATIONS in the following areas:

  GM                  Chrysler              Ford                  Toyota              

  Honda              Mercedes            Lexus                Jaguar             

  V.W./Audi        Acura                  Nissan               Subaru               

  BMW                Other            

10.  If you have any specialized training, please list below (technical or business related):

11.  Briefly tell us: 
          1. Why you would be an asset to our team, and
          2. Why you like the automotive industry. 

Use this space for other valuable comments or statements you would like to make your comments.
Do not paste resume' here - see #2 above, under "4 ways to submit your information".

 I authorize this company to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge. Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer. I agree to sign a confidentiality and customer and employee protection agreement as a pre-employment agreement. I authorized this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations. I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment will be conditional upon passing such examination. During such employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician. I further understand this is an application for employment and that no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and the company may change wages, benefits, and conditions at any time. My employment is at will. No individual with the company is authorized to change the employment-at-will status except an officer of the company, who may do so only in writing.  I have read and understand the above.   By clicking the "Submit Form" button below, I agree to ALL of the above and certify that ALL information I have entered herein is TRUE and valid.  I also agree and understand that by clicking "Submit Form" below, I am sending this information over the internet for review by the intended company named above. I also understand that clicking the "Submit" button, will be considered the same as signing my signature at the bottom of this form.

            I agree to the terms and conditions herein.