Shammy Shine Car Washes

Personal Information

Name:

Phone:

Address:

City:

State:

Zip Code:

Email (required):

Social Security Number:

Employment Desired

Position:

Date You Can Start:

Salary Desired:

Are you employed?

Yes No

If so, may we inquire of your current employer?

Yes No

Ever applied to Shammy Shine before?

Yes No

If yes, where and when?

Location you are applying for:

Allentown

Bethlehem

Clinton 1 (Center St. & Rt. 31)

Clinton 2 (West Main St.)

Easton

Flemington

Flemington Citgo Center

Milford 1 (Water St.)

Milford 2 (Frenchtown Rd.)

Palmer

Raritan

Washington

Education History

Name & Location of School	Years Attended	Did you Graduate?	Subjects Studied
High School
College
Trade or Business School

General Information

Subjects of special study/research work or special training/skills:

Former Employers

(List below the last four employers, starting with last one first)

Date (from and to)	Name & Address of Employer	Salary	Position	Reason for leaving

References

Name	Address & Phone	Business	Years Known

Authorization

"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."