| Date: |
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| Name: |
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| Phone #: |
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| Street Address: |
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| City: |
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| State: |
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| Zip Code: |
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| Social Security Number: |
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| Drivers License Number: |
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| Drivers License Expires: |
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| Drivers License Class: |
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Medical Card |
| High School: |
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I have a High School Diploma |
| College / Trade School: |
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TOWKING Certified |
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FSP Certified Los Angeles County |
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FSP Certified Orange County |
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TRAA Certified |
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CTTA Certified |
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Wreckmaster Certified |
| Military Background: |
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| Emergency Contact: |
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| Relationship: |
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| Phone: |
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| Emergency Contact Address: |
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| If hired, can you prove your eligibility to work in the United States: |
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| Have you ever been convicted of a Felony or Misdemeanor: |
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| If YES Explain: |
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| Will you volunteer to take a pre-employment DRUG TEST: |
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I know how to operate a FLATBED |
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I know how to operate a WHEEL LIFT |
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I know how to operate a SLING |
| EMPLOYMENT HISTORY |
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| Employer Name, Address, Phone, and contact person: |
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| Start Date: |
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| End Date: |
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| Reason for leaving: |
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| Hours Per Week: |
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| Ending Salary: |
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It is ok to contact this employer |
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| Employer Name, Address, Phone, and contact person:: |
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| Start Date: |
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| End Date: |
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| Reason for leaving: |
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| Hours Per Week: |
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| Ending Salary: |
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It is ok to contact this employer |
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| Employer Name, Address, Phone, and contact person: |
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| Start Date: |
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| End Date: |
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| Reason for leaving: |
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| Hours Per Week: |
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| Ending Salary: |
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It is ok to contact this employer |
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I certify that the answers given on this application are complete and correct to the best of my knowledge and belief. I understand that any false statement on this application is sufficient cause for rejection of my application or dismissal in the event that I am employed. I hereby grant permission to Bob and Dave’s Towing to contact my former employers concerning my personal character and qualifications for the position for which I applied. I also grant permission to each of my former employers
to provide Bob and Dave’s Towing, Incorporated information they have
with respect to such matter.
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