MECHANIC APP

Mechanic Application

Mundall Trucking, Inc. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she
should contact a company representative.

2102 W. Baseline Rd.
Phoenix, AZ 85041
Phone: (602) 276-0699 Fax: (602) 276-0717

APPLICATION FOR EMPLOYMENT AS MECHANIC

All fields with a red asterisk (*) require an entry. If the question does not apply, enter NONE or NOT APPLICABLE. Thank you.

* Indicates required field

Name *

First

Last

Address *

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City

State

Zip Code

Country

EMPLOYMENT POSITION SOUGHT *

Date of Birth (mm/dd/yyyy) *

Social Security Number (###-##-####) *

Home Phone *

Cell Phone *

Email *

Start Date Availability (mm/dd/yyyy) *

EMPLOYMENT POSITION

How did you hear about this position? *

WHAT DAYS ARE YOU AVAILABLE FOR WORK? *

WHAT HOURS OR SHIFTS ARE YOU AVAILABLE FOR WORK? *

ON WHAT DATE CAN YOU START WORKING IF HIRED? *

WHAT IS YOUR DESIRED SALARY? *

PERSONAL INFORMATION

ARE YOU A U.S. CITIZEN OR APPROVED TO WORK IN THE U.S.? *

Yes No

WHAT DOCUMENTS CAN YOU PROVIDE AS PROOF OF CITIZENSHIP OR LEGAL STATUS? *

DO YOU HAVE ANY CONDITION WHICH WOULD REQUIRE JOB ACCOMMODATIONS? *

Yes No

IF YES, PLEASE DESCRIBE REQUIRED ACCOMMODATIONS BELOW *

HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENSE (MISDEMEANOR OR FELONY)? *

Yes No

IF YES, PLEASE STATE THE NATURE OF THE CRIME(S), WHEN AND WHERE CONVICTED AND DISPOSITION OF THE CASE: *

JOB SKILLS & QUALIFICATIONS

PLEASE LIST BELOW THE SKILLS AND QUALIFICATIONS YOU POSSESS FOR THE POSITION FOR WHICH YOU ARE APPLYING: *

EDUCATION & TRAINING

NAME OF HIGH SCHOOL *

YEAR GRADUATED *

DEGREE EARNED *

ADDRESS OF HIGH SCHOOL *

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NAME OF COLLEGE OR UNIVERSITY *

YEAR GRADUATED *

DEGREE EARNED *

ADDRESS OF COLLEGE OR UNIVERSITY *

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State

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TRADE SCHOOL OR SPECIALIZED TRAINING *

YEAR GRADUATED *

DEGREE EARNED *

ADDRESS OF TRADE/VOCATIONAL SCHOOL *

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State

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MILITARY

ARE YOU A MEMBER OF THE ARMED FORCES? *

IN WHAT BRANCH OF THE MILITARY DID YOU SERVE? *

WHAT WAS YOU MILITARY RANK WHEN DISCHARGED? *

HOW MANY YEARS DID YOU SERVE IN THE MILITARY? *

WHAT MILITARY SKILLS DO YOU POSSESS THAT WOULD BE AN ASSET FOR THIS POSITION? *

EMPLOYMENT RECORD

Previous employer (Most recent on top)

Company Name *

Address *

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State

Zip Code

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Supervisor *

First

Last

Phone Number *

Fax Number *

Position Held *

Start (mm/dd/yyyy) *

End (mm/dd/yyyy) *

Reason for Leaving *

Previous employer

Company Name *

Address *

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City

State

Zip Code

Country

Supervisor *

First

Last

Phone Number *

Fax Number *

Position Held *

Start (mm/dd/yyyy) *

End (mm/dd/yyyy) *

Reason for Leaving *

Previous employer

Company Name *

Address *

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City

State

Zip Code

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Supervisor *

First

Last

Phone Number *

Fax Number *

Start (mm/dd/yyyy) *

End (mm/dd/yyyy) *

Reason for Leaving *

REFERENCES

FIRST REFERENCE NAME *

First

Last

YEARS KNOWN *

Email *

Address *

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State

Zip Code

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Phone Number *

SECOND REFERENCE NAME *

First

Last

YEARS KNOWN *

Phone Number *

Email *

Address *

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State

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AT-WILL EMPLOYMENT

The relationship between you and the Mundall Trucking, Inc. is referred to as employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Mundall Trucking, Inc .. No representative of Mundall Trucking, Inc. has
authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make sure investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, healthcare providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by all rules and regulations of the Company.

"I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

Review information provided by current/previous employers;
Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer, and
Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information."

Applicant's Name *

First

Last

Today's Date (mm/dd/yyyy) *

By checking the box below, you are providing your digital signature to this application *

I have read the above statement and agree to the terms therein

I AGREE