Employment

Name
Position Applied For
Email Address
Present Address
City, State & Zip
Business Phone
Home Phone
Salary Requirements
Date Available
Are you available to work:
Saturdays? Yes No
Sundays? Yes No
Full Time? Yes No
Part Time? Yes No
Nights? Yes No
Do you have legal right to work in the U.S.? Yes No
Have you ever been employed by Wantagh Mitsubishi? Yes No

Previous Employers

Please list previous employers. List most recent employer first.
May we contact your present employer? Yes No
Company
Supervisor
Starting Salary
Salary Ending
Dates of Employment
Title of Position and Duties Performed
Phone Number
Street Address
City, State & Zip
Reason for Leaving
Company
Supervisor
Starting Salary
Salary Ending
Dates of Employment
Title of Position and Duties Performed
Phone Number
Street Address
City, State & Zip
Reason for Leaving
 
Company
Supervisor
Starting Salary
Salary Ending
Dates of Employment
Title of Position and Duties Performed
Phone Number
Street Address
City, State & Zip
Reason for Leaving
Company
Supervisor
Starting Salary
Salary Ending
Dates of Employment
Title of Position and Duties Performed
Phone Number
Street Address
City, State & Zip
Reason for Leaving
Please explain any special compensation (including bonus) on any of the jobs you have held.
List any award or recognition you received for your job performance, professional, contributions or memberships.

Business References

Give the names, titles, addresses and phone numbers of three business references
(we will not contact present employer without prior approval).
Name
Company and Address
Phone
Years Known
Name
Company and Address
Phone
Years Known
Name
Company and Address
Phone
Years Known
By submitting this credit application, I verify that the information provided is complete and accurate to the best of my knowledge.
I futher authorize an investigation of my credit and employment history.
I accept the terms of the Privacy Policy.
Toll Free Hotline 1-800-4-Wantagh
(1-800-492-6824)