Position you are applying for:

Personal Information

*Name:                           Date of birth:

*Email:                                

*Address:                     *City:               

*State:                           *ZIP Code:     

*Home phone:                Cell Phone:   

_________________________________________________________________________________________

Educational Background

High School:      Years:    Graduated?

College:             Years:    Graduated?      Major:

Trade/Tech School:        Years:    Graduated?      Major:

Special interests or hobbies:

_________________________________________________________________________________________

Business Experience

Current Employer:            

Business address:                   City:            

State:                                       ZIP Code:    

Type of business:                     Position:     

Length of employment:               

Previous Employer:         

Business address:                    City:            

State:                                        ZIP Code:   

Type of business:                     Position:     

Length of employment:             

_________________________________________________________________________________________

References

Business:    
1:      Phone:
2:      Phone:
3:      Phone:

Personal:    
1:      Phone:
2:      Phone:
3:      Phone:

* I understand that submission of this application does not constitute acceptance by Alloy Wheel Repair Specialists
and that this information will be held in the strictest confidence.

*Date: