ApplicationForm Contact information Thank you for your interest in joining the Momentum Team. Allow us to get to know you better by completing the below employment application. #FindYourMomentumName(Required) First Middle Last Address(Required) Street Address City State ZIP / Postal Code Best Contact Phone(Required)Email(Required) Position Desired: Have you ever applied for employment with us? Yes No If yes: Month & Year Prefered Location Gastonia - 714 Union Rd Hickory - 1040 Lenoir Rhyne Blvd Morganton - 1908 S Sterling St Hickory - 2663 US Hwy 70 SE Other What is your availability? Full Time Part Time What is your schedule availability? Are you available Saturdays? Yes When will you be available to begin work? Are you at least 18 years of age? Yes No Tell us about any certifications (ex. ASE), special training, skills (ex. languages), awards, or special accomplishments: Pay Expected Are you authorized to work in the United States?All applicants must furnish documents that prove you are legally qualified to work in the United States. Yes No Do you have a valid driver’s license?(Required) Yes No State in which driver's license issued. Have you received any traffic violations in the last (5) years? Yes No If yes, please list all traffic violations you have received.Additional InfoHave you served in the U.S. Armed forces?If so, we appreciate your service! Yes No Branch: If “Yes”, what type of discharge did you receive? Honorable General Medical Dishonorable Other than Honorable Still Active Have you been convicted of any felony or misdemeanor crimes within the past 10 years, or are any charges pending or are you awaiting trial on charges for such crimes? Yes No If “yes” please describe in full:Many jobs at Momentum require some medium (20 to 50 lbs.) to heavy (over 50 lbs.) lifting. Are you qualified physically for the job for which you are applying?(Required) Yes No Would you require any special accommodation to perform this job? Yes No If yes, please describe:EducationHigh SchoolDo you have a high school diploma or equivalent?(Required) Yes No Name & Location of School Did you take any automotive classes in high school? Yes No College / UniversityName & Location of School Course of Study # of years completed Degree Did you Graduate? Yes No College / UniversityName & Location of School Course of Study # of years completed Degree Did you Graduate? Yes No Employment PLEASE GIVE ACCURATE, COMPLETE, FULL TIME AND PART TIME EMPLOYMENT, STARTING WITH YOUR PRESENT OR MOST RECENT EMPLOYER. DO NOT PUT “SEE RESUME”. Include all work history, even if it does not directly relate to the job for which you are applying.Company #1Company Name City City State State / Province / Region Name of Supervisor Ok to contact? Yes No PhoneState job title & describe your work Employed From (Month & Year) Employed To (Month & Year) Average Hours Per Week Weekly Pay Start Weekly Pay End Reason for leaving: Company #2Company Name City City State State / Province / Region Name of Supervisor Ok to contact? Yes No PhoneState job title & describe your work Employed From (Month & Year) Employed To (Month & Year) Average Hours Per Week Weekly Pay Start Weekly Pay End Reason for leaving: Company #3Company Name City City State State / Province / Region Name of Supervisor Ok to contact? Yes No PhoneState job title & describe your work Employed From (Month & Year) Employed To (Month & Year) Average Hours Per Week Weekly Pay Start Weekly Pay End Reason for leaving: Company #4Company Name City City State State / Province / Region Name of Supervisor Ok to contact? Yes No PhoneState job title & describe your work Employed From (Month & Year) Employed To (Month & Year) Average Hours Per Week Weekly Pay Start Weekly Pay End Reason for leaving: What additional information would you like us to know when considering you for an opportunity with us? ** NOTICE TO ALL APPLICANTS – PLEASE READ CAREFULLY ** Momentum Car Care is proud of its employees and strives to hire the best candidates. Before you apply, please note the following information: Momentum Car Care wishes to provide a drug free environment for employees and customers. The company has a drug testing program, which includes pre-employment testing. If selected for employment, you may be required to pass a drug screen and physical exam. You must complete the employment application in full; do not put “see resume”. Failure to provide complete information or providing false information can result in you not being considered for employment or dismissed from employment. We do check previous employers to verify past employment unless you specifically request that we do not contact them and state your reason. We will also check public records for any criminal convictions and driving record. Momentum Car Care is an equal opportunity employer. Prospective employees will receive consideration without discrimination based on race, creed, color, sex, age, national origin, veteran status, marital status, disability, handicap, sexual orientation, citizenship status or any condition prescribed by law. I have read and understand the above and give Momentum Car Care express permission to check previous employment references (except as noted on the Employment Application), perform a criminal record check and driving record.Attach Resume (Optional)Accepted file types: jpg, gif, png, pdf, Max. file size: 32 MB.Untitled Electronic SignatureUntitled Date
