Welcome to Automotive Quality & Logistics

Date:
Position Applied for:
Location :

Automotive Quality & Logistics, Inc.
EMPLOYMENT APPLICATION

AQL HR Application Process	Date Verified	AQL Personnel Signature
Personal Interview
	Driver's License Verified and on File
	SSN Verified
	Reference Checks Completed and Attached
	Background Check Completed
	New Hire Reporting Completed
	Drug test (if applicable)

The above checklist is to be completed by AQL personnel only upon hire of above applicant. Anyone found not to be in compliance is subject to termination per AQL policies and procedures.

PERSONAL INFORMATION

This information will not be the only basis for hiring decisions. You are not required to furnish any information that is prohibited by federal, state, or local law.

Last Name:	First Name:	Middle Name:
City:	State:	Zip Code:
Phone (Primary):( ) -	(Cell):	Email:

EMPLOYMENT HISTORY

Please start with your present or most recent position and include all previous full-time jobs in chronological order, attach resume if available.

Current or Last Employer:

Employer Address:

Phone:

( ) -

Type of Business:

Your Position:

Employed From

/ / to / / (mm/dd/yyyy)

Type of Work:

Starting Base Wage:

Final Base Wage:

Reason for leaving:

May we contact your previous employer?

Yes No

Supervisor Contact:

( ) -

Previous Employer:

Employer Address:

Phone:

( ) -

Type of Business:

Your Position:

Employed from:

/ / to / / (mm/dd/yyyy)

Type of Work:

Starting Base Wage:

Final Base Wage:

Reason for leaving:

May we contact your previous employer?

Yes No

Supervisor Contact:

( ) -

Previous Employer:

Employer Address:

Phone:

( ) -

Type of Business:

Your Position:

Employed from:

/ / to / / (mm/dd/yyyy)

Type of Work:

Starting Base Wage:

Final Base Wage:

Reason for leaving:

May we contact your previous employer?

Yes No

Supervisor Contact:

( ) -

EDUCATION

Please check highest grade completed:	1 2 3 4	1 2 3 4 5 6 7 8
	High School	College

Other

1.	Do you have the legal right to work for any employer in the United States? Yes No
2.	Have you ever been convicted of a crime (other than a minor traffic violation)? Yes No
3.	If so, please explain:
4.	Are you willing to take a Drug Test TODAY if hired? Yes No
5.	Are there any challenges that you face (in or out of the workplace) that you would like us to be aware of? Yes No If yes please explain:
6.	Do you have any personal or professional commitments that you would like to tell us about?
7.	Have you ever been employed by AQL in the past? If yes, please list date(s) and position(s):
8.	Is your Driver's License valid, and can you legally drive? Yes No
9.	What date are you available to begin work? / / (mm/dd/yyyy)
10.	AQL has client locations throughout the area, and you are expected to drive to our client's sites for your work assignment. Can you personally drive to these locations, without relying upon others? Yes No
11.	Occasionally, you may be asked to drive over 60 miles to a client's location, and you will be paid additional compensation for your Drive Time. Are you willing to accept this type of assignment? Yes No
12.	Are you willing to work over time? Yes No
13.	Type of employment desired: Full Time Part Time
14.	How were you referred to AQL? Friend Newspaper Internet Other Please specify the name of the source:

WORK RELATED REFERENCES
Provide at least 3 work related/professional references. They may be current or former supervisors, employers/business owners, instructors, teachers and/or other professional contacts.

REFERENCE 1

REFERENCE 2

NAME:
JOB TITLE:
BUSINESS ADDRESS:
BUSINESS PHONE:
OTHER ADDRESS:
OTHER PHONE:
RELATIONSHIP:
YEARS AQUAINTED:

NAME:
JOB TITLE:
BUSINESS ADDRESS:
BUSINESS PHONE:
OTHER ADDRESS:
OTHER PHONE:
RELATIONSHIP:
YEARS AQUAINTED:

REFERENCE 3

REFERENCE 4

NAME:
JOB TITLE:
BUSINESS ADDRESS:
BUSINESS PHONE:
OTHER ADDRESS:
OTHER PHONE:
RELATIONSHIP:
YEARS AQUAINTED:

NAME:
JOB TITLE:
BUSINESS ADDRESS:
BUSINESS PHONE:
OTHER ADDRESS:
OTHER PHONE:
RELATIONSHIP:
YEARS AQUAINTED:

ACKNOWLEDGEMENT & RELEASE
I certify that the answers given in this application for employment are true and complete to the best of my knowledge. I have provided requested information about all my previous jobs, and authorize investigation into all statements I have made on this form as may be necessary for reaching an employment decision.

In the event I am employed by Automotive Quality & Logistics, I understand that any false or misleading information that I knowingly provide in this application for employment or interview(s) may result in discharge or legal action. I also understand that if employed, I will be contacted for work as it becomes available, and that I am guaranteed neither a minimum nor maximum number of hours per week. I am also required to abide by all rules and regulations as set forth by Automotive Quality & Logistics (AQL), Inc. and any special agreements reached between AQL and me.

Signed: Date: / / (mm/dd/yyyy)