General Information
First Name:
Last Name:
Address:
City:
State:
(Choose State)
MD
VA
DC
WV
Zip Code:
Telephone number:
Email Address:
Desired Position:
(Pick One)
Manager
Assistant Manager
Technician
Customer Service Adv
Are You Legally Entitled To Work In the US?
YES
NO
If no, please explain
Do You Currently Have A Valid Driver's License?
YES
NO
Have You Previously Worked For Jiffy Lube?
YES
NO
If yes, please explain
Are You Currently Employed?
YES
NO
If yes, please explain
Education
Choose Highest Grade Completed
(Pick One)
6
7
8
9
10
11
12
College(1)
College(2)
College(3)
College(4)
Grad(1)
Grad(2)
Grad(3)
Grad(4)
Other(1)
Other(2)
High School (Name,City,State)
Degree?
College Name (Name,City,State)
Degree?
Vocational(Name,City,State)
Degree?
Other(Name,City,State)
Degree?
Explain Other
Technical Skills/Experience (Please explain any additional skills you may have)
Automotive Training
Management Training
Other Training Or Skills (Please Describe)
Work Experience (Please fill in the last three jobs you have had)
JOB #1
Company Name:
Address:
Dates Employed (mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and Description (Give full descriptions of duties, responsibilities and equipment used)
JOB #2
Company Name:
Address:
Dates Employed(mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and Description (Give full descriptions of duties, responsibilities and equipment used)
JOB #3
Company Name:
Address:
Dates Employed (mm/yy-mm/yy):
Reason For Leaving:
Supervisor's Telephone:
Job Title and Description (Give full descriptions of duties, responsibilities and equipment used)
Additional Information
Location Preference:
Minimum Wage/Salary Requirements:
Date Available To Start:
Are You Willing To Work Overtime And Weekends?
YES
NO
If No, Why Not?
