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BASIC INFO
Full Name
Primary Phone Number
Secondary Phone Number
Current Address
From
Previous Address
From
To
Position Desired
Vomac Location
Select A Location
Evansville
New Haven
Seymour
Terre Haute
Vincennes
Salary Required
Available Date
Military Service (Branch, years served, presently in Reserve or National Guard)
Are you on another persons' Life Insurance?
Yes
No
Are you on another persons' accident insurance?
Yes
No
Who should be contacted in case of an emergency? (Name, Address, and Phone Number)
Is he/she a family member?
Yes
No
Do you have a valid drivers license?
Yes
No
It may be necessary to obtain a copy of your driving record as a condition of employment. Do we have your permission to do so if necessary?
Yes
No
Initial Here
EDUCATION
Grade School(s) - Name, Address, Years Attended
High School(s) - Name, Address, Years Attended
Did you graduate high school?
Yes
No
College(s) - Name, Address, Years Attended
Did you graduate college
Yes
No
Major and Degrees
Business, trade, or corresp. school(s) - Name, Address, Years Attended, Degrees earned (if any)
Have you had any special courses in the automobile field?
Yes
No
While in school, what outside activities did you take part in? (Varsity or intramural sports, clubs, etc.)
RECORD OF EMPLOYMENT
Employer Name
Your Supervisor
Address
Start Date (Month and Year)
End Date (Month and Year)
Total Length of Service
Kind of work
Reason for leaving
Average Weekly Earnings
Employer Name
Your Supervisor
Address
Start Date (Month and Year)
End Date (Month and Year)
Total Length of Service
Kind of work
Reason for leaving
Average Weekly Earnings
Explain any gapes in your employment history set forth above
Show Actual Experience by checking the following
Shop Supervisor
Computer Operator
Mechanic
Mechanic Helper
Dynamometer
Electrician
Body Mechanic
Painter
Helper
Radio
Service Writer
Trimmer (Upholster)
Motorcycle
Gen. Garage Worker
Lubrication
Service Dispatcher
Chauffeur
Porter
Janitor
Security
Car Washer
Polisher
Parts Manager
Parts Clerk
Messenger
Sales Manager
Used Car Sales Person
New Car Sales Person
Truck Sales Person
Office Manager
Receptionist
Bookkeeper
Cashier
Sec’y-steno
Clerk
Typist
EDP
Business Machines Used
Personal References (Give persons who know you well, no pervious employers or relatives)
Name, Occupation, Address (Street, City, and State), No. of years this person has known you
Name, Occupation, Address (Street, City, and State), No. of years this person has known you
Name, Occupation, Address (Street, City, and State), No. of years this person has known you
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