Employment Application

Employment Application

This company is an equal opportunity employer. This company does not discriminate on the basis of race, national origin, creed, sex, sexual orientation, age, religion, national origin, citizenship, disability, pregnancy or pregnancy related medical conditions, handicap, veteran status, or any other factor prohibited by local, state or federal law. We also provide reasonable accommodations to qualified applicants and employees with disabilities or those with qualifying conditions related to pregnancy or childbirth. Any applicant who requires an accommodation to perform the essential functions of the job for which he or she is applying should notify Human Resources or your local management. The application shall be effective for 30 days after today's date. If you have questions or need help with the application, please let us know so that we can assist you. This is not a contract. This employment application is being used for the sole purpose of determining if you are qualified for the job. It is very important to answer all questions accurately. If you make false or misleading statements on this employment application or during the interview, upon discovery, it will be grounds for rejecting your applicaiton or terminating your employment.
Store Location Information
Please Select State Applying To

IndianaIllinois
Please Select Location Applying To

Goshen North - Greene RoadGoshen South - CaraganaWakarusaMiddleburyTruck & Farm Goshen - Greene RoadElkhart North - CassopolisElkhart South - BeardsleyBest-One PlymouthWarsaw RetailWarsaw CommercialCorporate OfficeBest-One Ashkum, IllinoisBest-One Kankakee, IllinoisNappaneeSilver Lake
Employment Desired
For which position are you applying?

Tire & Lube TechnicianAutomotive Repair TechnicianRetail Sales CounterOffice AdministrationOutside SalesOther
Are you seeking Full-Time or Part-Time Employment?

Full-Time EmploymentPart-Time Employment
Personal Information
Name*

First NameMiddle NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Email Address
Are you legally eligible for employment in the United States?

YesNo
Are you 18 years of age or older?

YesNo
How did you hear about the position?

AdvertisementWalk InEmployee or RelativeEmployment AgencyOther
If hired, what date can you start work?

MonthDayYear
Date
Depending on customer demands, this position may require availability to work Monday - Saturday of a given week and/or overtime hours. Are there any days/hours on which you are unavailable to work?

YesNo
If yes, which days and hours are you unavailable for work?
Can you travel if the job requires out-of-town work?

YesNo
Have you previously applied for employment with the Company?

YesNo
If yes, date

MonthDayYear
Date
Employment History
Please list the names of your present and/or previous employers with the present or most recent employer listed first. Please, provide complete address, phone number and contact for all previous employers. By doing so you give consent for the Company to contact the businesses indicated below.
Employment History

Employer 1
Name of Employer
Job Title
Phone Number
Type of Business
Supervisor

TitleFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Description of job and duties
Is this your current employer?

YesNo
May we contact this employer for a reference?

YesNo
Were you terminated or discharged from this job?

YesNo
Did you quit under threat of discharge?

YesNo
Reason for leaving:
Employment History

Employer 2
Name of Employer
Job Title
Phone Number
Type of Business
Supervisor

TitleFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Description of job and duties
Is this your current employer?

YesNo
May we contact this employer for a reference?

YesNo
Were you terminated or discharged from this job?

YesNo
Did you quit under threat of discharge?

YesNo
Reason for leaving:
Employment History

Employer 3
Name of Employer
Job Title
Phone Number
Type of Business
Supervisor

TitleFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Description of job and duties
Is this your current employer?

YesNo
May we contact this employer for a reference?

YesNo
Were you terminated or discharged from this job?

YesNo
Did you quit under threat of discharge?

YesNo
Reason for leaving:
Education, Training and Experience
High School Name
High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School: Number of years completed
Did you graduate high school?

YesNo
High School Degree or Diploma
College/University Name
College/University Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University: Number of years completed
Did you graduate college or university?

YesNo
College/University Degree or Diploma
Vocational, Trade, Graduate, etc. School Name
Vocational, Trade, Graduate, etc. School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vocational, Trade, Graduate, etc. School: Number of years completed
Did you graduate Vocational, Trade, Graduate, etc. school?

YesNo
Vocational, Trade, Graduate, etc. School Degree or Diploma
Please provide any additional information that you believe would assist us in better evaluating your application:
If you have any job-related training that you received, whether from an employer listed above, from the United States Military, or from another source, please provide details:
References

Please list three people, who are not related to you and who are not previous supervisors, that you have known for at least one year, and whom we may contact as additional references.
References

Reference 1
Name

First NameLast Name
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship
Years Known
References

Reference 2
Name

First NameLast Name
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship
Years Known
References

Reference 3
Name

First NameLast Name
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship
Years Known
If you would like to upload a resume or cover letter please do so below.

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Applicant Statement
This signature certifies that this Employment Application was completed by me, and that all entries on it and information contained in it are true and complete to the best of my knowledge.*

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Print Name*

First NameLast Name
Date

MonthDayYear
Date
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