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Mikes Trucking Inc
.
3302 Pluto Street, Dallas, Texas 75212
office (214) 905.9202 fax (214) 905.1975
AN EQUAL OPPORTUNITY EMPLOYER
APPLICATION FOR EMPLOYMENT
Date: _________
Please Print and fax to (214) 905.1975
PERSONAL
Name: _____________________________________ Soc. Sec. # _____________________________
Present Address : ___________________________________________________________________
No.
Street
City
State
Zip
Previous Address:___________________________________________________________________
Are you 18 years of age or over?
Are you a U.S. citizen?
Yes
Yes
No
Phone No. ___(___)________-___________
No
Do you have a valid operators (drivers) license?
Yes
No
If yes, license number and state ________________________________________________________
EMERGENCY CONTACT
In case of an emergency notify: Name: __________________________________________________
Address: __________________________________________________________________________
Phone:
__(___)____________________________________________________________________
EMPLOYMENT DESIRED
Position: ________________________ Date you can start: ___________ Salary desired: __________
Type of Employment Desired:
Part-time
Full-time
Temporary
Day
Evenings
Weekends
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EDUCATION
Name and Location of School
No. of
Years
Attended
Graduated?
Yes / No
Course
Or
Major
High School
College
Other Education
EMPLOYMENT HISTORY
List your record of employment beginning with your present or most recent position.
Dates
From
To
Name and Address of Employer Position
Supervisors
Name
and Title
Reason for
Leaving
Describe the work you did:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
EMPLOYMENT HISTORY (continued)
Dates
From
To
Name and Address of Employer Position
Supervisors
Name
and Title
Reason for
Leaving
Describe the work you did:
_________________________________________________________________________________
_________________________________________________________________________________
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_________________________________________________________________________________
Dates
From
To
Name and Address of Employer Position
Supervisors
Name
and Title
Reason for
Leaving
Describe the work you did:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
May we contact the employers listed above?
one(s) you do not wish us to contact.
Yes
No
If not, indicate which
______________________________________________________________________________
THREE (3) REFERENCES: ______________________________________________________
______________________________________________________
______________________________________________________
I authorize Mikes Trucking Inc. to contact former employers and references. 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.
_________________________________________
Applicants Signature
_____________________________
Date
