Contact

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Applicant Information

First Name:

Middle:

Last Name:

Phone:

Email:

Street Address:

City:

State:

Zip:

Position Applied For:

Type of employment desired:

Full-time

Part-time

Temporary

Desired Pay: $

Valid Driver's License Number:

State:

Are you a citizen of the United States?

Yes

If no, are you authorized to work in the U.S.?

Yes

Have you ever worked for this company?

Yes

If the answer is YES to any of the questions above, please explain in a statement below giving details:

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Driving History & Legal

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Yes

Have you ever been arrested?

Yes

Have you ever been convicted of a felony?

Yes

Do you have any traffic violations (in the last 7 years)?

Yes

Has any license, permit or privilege ever been suspended or revoked?

Yes

If the answer is YES to any of the questions above, please explain in a statement below giving details:

Driving Experience

Driving Experience

List Equipment Class (Example: Class A 1-Ton, Class B 2-Ton, Class C Semi, Class E Flatbed)

Equipment Class / Type

Manufacturer Type

Dates Operated

Equipment Class / Type

Manufacturer Type

Dates Operated

Equipment Class / Type

Manufacturer Type

Dates Operated

Education

Education

High School:

Address:

College:

Degree:

Professional References (List 3)

Professional References (List 3)

Reference 1: Name:

Phone:

Relationship:

Reference 2: Name:

Phone:

Relationship:

Reference 3: Name:

Phone:

Relationship:

Previous Employment

Previous Employment

Company 1:

Supervisor:

Supervisor Phone:

Job Title:

From:

To:

Company 2:

Supervisor:

Supervisor Phone:

Job Title:

From:

To:

Company 3:

Supervisor:

Supervisor Phone:

Job Title:

To:

From:

Disclaimer and Signature

Disclaimer and Signature

Field label

I certify that all information I have provided in order to apply for and secure work with Timberline Towing & Recovery, LLC. are true and complete to the best of my knowledge. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect will be sufficient cause to cancel further consideration of this application, or whenever discovered, to immediately discharge me from service. I expressly authorize, without reservation, the employer and its agents to contact and obtain information from all references, public agencies, licensing authorities, and educational institutions to verify the accuracy of all information provided by me. I hereby waive any and all rights and claims regarding the employer for seeking and using such information and hold harmless all entities for furnishing such information. I understand that this application remains current for only 60 days. If I am hired, I understand that my employment is “at-will”, meaning I am free to resign at any time and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice. This application does not constitute an agreement or contract for employment for any specified duration. I understand that if I am hired, I must provide proof of identity and legal authority to work in the United States per federal immigration laws. I further understand that any offer of employment is conditional upon my successfully passing a drug test. Note to Applicant: Do not sign until you have read the above statement.

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