WARD’S MOBILE FLEET REPAIR - APPLICATION Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Social Security Number: Email * Phone * (###) ### #### How long have you resided at current address? Prior Address Address 1 Address 2 City State/Province Zip/Postal Code Country Are you over 18 years of age? Yes No Sex: Male Female Names of friends or relatives who presently work for Ward's Mobile Repair Fleet: Emergency Contact Information - NAME: Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country How is this person related to you? Employment Position: Date Started: Starting Salary: Job Responsibilities: Training Requirements: Please list the type of training, the location, the amount of time needed, and the dates. Previous Relevant Training: Please list the date of training, the location, and describe the training received. Please list any foreign languages you speak, and describe your level of fluency: List any special skills / abilities you have that can be applied to this position. Have you served in the military? Yes No Branch of Military: Do you have any military commitment, including National Guard service that would influence your work schedule? Yes No If yes, please explain: Are you a Vietnam veteran? Yes No Are you a disabled veteran? Yes No Are you a special disabled veteran? Yes No REASONABLE ACCOMMODATIONS: In the event you believe you will need reasonable accommodations to assist you in performing your job, please contact your supervisor or Human Resources coordinator. Additional information you'd like to include: By clicking "Apply Now", I certify that the facts contained in this form are true and complete to the best of my knowledge and understand that if employed, falsified statements on this form will be grounds for dismissal. Thank you!
