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Contact Information
First Name
*
Last Name
*
SSN (Optional)
Street Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
Employment Desired
Applying for Position:
*
Driver
Dispatcher
Sales
Mechanic
Other
Other
Date you can begin:*
*
+
Salary desired
Employment Sought
*
Full Time
Part Time
Either Option
Do you have any prior experience in the towing industry?
*
YES
NO
Are you currently employed?
Yes
No
Can we contact your employer?
Yes
No
Do you have clean driving record?
Yes
No
Please Explain Record
Can you, at the time of employment, submit verification of your legal right to work in the United States?
YES
NO
Education
Highest Educational Level Achived
*
High School
College
Other
Other
High School
High School Location
Did you graduate from High School?
YES
College
College Location
Did you graduate from College?
YES
Survey
Why are you interested in becoming an employee with Specialized Towing?
What are your career goals?
How did you find out about the open position?
Employment History
Company Name (Last)
Job Title (Last)
Supervisor (Last)
Telephone (Last)
Dates of Employment (Last)
Reason for Leaving (Last)
Company Name (Previous)
Job Title (Previous)
Supervisor (Previous)
Telephone (Previous)
Dates of Employment (Previous)
Reason for Leaving (Previous)
References — List 3 Individuals
Contact Name
Relationship
Telephone
Contact Name
Relationship
Telephone
Contact Name
Relationship
Telephone
Have you ever been convicted of a felony?
YES
NO
Please explain case
Please enter your Drivers License number
*
If possible upload a picture of your Drivers License (Optional)
Additional Comments