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Location* Location*4139 North Valdosta Rd. Valdosta, GA

Today's Date*

First Name*

Middle Name

Last Name*

Birth Date*

Street Address/ Unit number*

Address Line 2 (optional)

City*

State* State*AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code/Postal*

Phone *

Email *

Can you, after employment, submit verification of your legal right to work in US? * Can you, after employment, submit verification of your legal right to work in US? * Yes No

Please explain: *

Do you have reliable transportation? Do you have reliable transportation? Yes No

Please explain: *

Do you have a valid driver’s license? * Do you have a valid driver’s license? * Yes No

Please explain: *

Have you ever been convicted of a crime? * Have you ever been convicted of a crime? * Yes No

Please explain: *

Have you ever been employed before? * Have you ever been employed before? * Yes No

Company *

Phone Number *

Address, City, State, ZIP *

Supervisor *

Job Title *

Hourly Rate *

From *

To *

Were you let go? * Were you let go? * Yes No

Reason for leaving? *

High School *

Address, City, State, ZIP *

College

Address, City, State, ZIP *

Have you graduated? * Have you graduated? * Yes No

Year Graduated *

Expected Graduation Year *

Trade School or Other

Address, City, State, ZIP *

Have you graduated? * Have you graduated? * Yes No

Year Graduated *

Expected Graduation Year *

Date you can start: *

Wages Desired (Hourly Rate) *

Are you looking for full or part time employment? * Are you looking for full or part time employment? * Full Time Part time

We are open 7 days a week. Can you work weekends? * We are open 7 days a week. Can you work weekends? * Yes No

How far do you live from this car wash? *

Morning * Morning * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Not available

Evening * Evening * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Not available

Comment

For which position are you applying? * For which position are you applying? * Customer Service Agent: Seeking energetic, Hard working, Enthusiastic People – No experience required. Shift Supervisor: Carwash or Retail experience required, Professional, Enthusiastic, Motivated Site Manager: Management Experience Required, Dedication, Hard working, Positive motivator