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Safety First Professional Driving School, Inc. 3186 State Highway 27 Kendall Park, New Jersey 08824 Phone 1-800-237-1095 |
Pre-employment Questionnaire Equal Opportunity Employer |
Date: ______________________
Personal Information| Name: | Social Security Number: |
| Present Address: | City: Zip Code: |
| Telephone: | Referred By: |
| Driver's License Number: | |
| Position: | Date You Can Start: | Salary Desired: |
| Are you Employed: Yes / No | If Yes, May We Inquire of Your Present Employer: Yes / No | |
| Name of School | Attended From / To | Did you Graduate? | Subjects Studied | |
| High School | ||||
| College | ||||
| Trade or Business |
| Special Interests / Studies / Research Work: |
| Date | Company Name & Address | Salary | Position | Reason for Leaving |
| From To | ||||
| From To | ||||
| From To |
| Name | Address / Phone Number | Business | Years Known |
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."
| Date: | Signature: |
| Interviewed by: | Date: |