Employment – Panache Car Wash

Employment Application Form

Step 1 of 5

Your Personal Information

Your Name

First Last

Your Email Address

Enter Email Confirm Email

Address

Street Address Address Line 2 City State ZIP Code

Phone

Best Time To Call You

When is the best time for us to reach you via telephone?

Panache Employee Referral

If you were referred for this position by a Panache employee indicate their name here:

Position You're Applying For

Position

Hours You Are Available for Work

Please tell us what hours you are available for work each day of the week.

Monday

Tuesday

Wednesday

Thursday

Friday

Previous Employment 1

Start with last employer

From Date

To Date

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Pay Rate Start

Pay Rate Last

Supervisor's Name

Phone

Job held and responsibilities

Reason for leaving

Previous Employment 2

From Date

To Date

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Pay Rate Start

Pay Rate Last

Supervisor's Name

Phone

Job held and responsibilities

Reason for leaving

Previous Employment 3

From Date

To Date

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Pay Rate Start

Pay Rate Last

Supervisor's Name

Phone

Job held and responsibilities

Reason for leaving

Reference 1

Please give the names of at least two persons not related to you whom may have known you for at least one year

Name

First Last

Business

Address

Street Address Address Line 2 City State ZIP Code

Years Acquainted

Phone

Reference 2

Name

First Last

Business

Address

Street Address Address Line 2 City State ZIP Code

Years Acquainted

Phone

Reference 3

Name

First Last

Business

Address

Street Address Address Line 2 City State ZIP Code

Years Acquainted

Phone

Emergency Contact

In case of emergency, please notify:

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code