MMAuto Application for Employment - M&M Auto Parts, Inc.

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M & M Auto Parts, Inc.

1489 Jefferson Davis Highway

Fredericksburg, VA 22405

Mailing Address

P. O. Box 147

Stafford, VA 22555

APPLICATION FOR EMPLOYMENT

Personal Information

Submit

Fredericksburg: (540) 720-1000

Stafford: (540) 659-2211

N. Va/Metro DC: (703) 385-9555

Tidewater: (757) 447-6051

Toll Free: (866) 263-6189

EBay Sales: (866) 263-6265

Fax: (540) 659-2090

Application Date:

Name (Last, First):

Present

Address:

Permanent

Address:

City:

State:

City:

State:

Phone Number:

Referred By:

VA

ZIP:

ZIP:

Employment Desired

Date You

Can Start:

Position:

Are You Currently

Employed?

Yes

No

Have you ever applied to M&M Auto

for employment before?

Education History

If so, May we inquire of

your current employer?

Yes

Salary Desired:

Yes

No

Are you legally authorized

to work in the US?

If Yes, what position

No did you apply for?

Name & Location of School

Yes

When?

Years

Attended

Did You

Graduate?

Subjects Studied

High School:

College:

Trade, Business or

Correspondence School:

General Information

Subject of Special

Study/Research Work:

Special Training:

Special Skills:

US Military or

Naval Service:

Rank:

Former Employers (List below last four employers starting with last one first)

Date

From:

To:

From:

To:

From:

To:

From:

To:

Name & Address of Employer

Telephone

Position

Reason for leaving

No

References (Give below the names of three persons not related to you, whom you have known at least one year)

Name

Address

Business

Telephone

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 immediate dismissal.

I authorize M&M Auto Parts, Inc. or their designee to investigate all statements 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 utilizations of such information.

I also understand and agree that no representative of M&M Auto Parts, Inc. has any authority to enter into any agreement for employment for any

specific period of time, or to make any agreements contrary to the foregoing, unless it is in writing and signed by an authorized M&M Auto Parts, Inc.

representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities

Act (ADA) and other relevant federal and state laws."

Signature:

Date:

DO NOT WRITE BELOW THIS LINE

Interviewed by:

Date:

Remarks

Neatness:

Character:

Personality:

Ability:

Hired:

HR Manager:

Position:

Will report to:

General Manager:

Salary:

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