PRE-EMPLOYMENT QUESTIONAIREEQUAL OPPORTUNITY EMPLOYER

DATE__________________________

Name______________________________________________________________________Last First Middle

Present address____________________________________________________________________

Number Street City State Zip

How long at current address___________________

Social Security No. _______-_______-_______

Telephone ( )_______-_________

Are you under age 18 ____ YES ____ NO, if “YES”, can you provide proof of your eligibility to work? ____YES ____N0Are you either a U.S. Citizen or an alien authorized to work in the United States? ____YES _____NO. Proof of eligibility will be required if hired.

Employee Referral? Name____________________________________________

EDUCATIONTYPE OF SCHOOL

NAME OF SCHOOL

LOCATION NUMBER OF YEARS

COMPLETED

MAJOR & DEGREE

High School

College

Bus. or Trade School

Professional School

PERSONAL INFORMATION

Employment Application Form

Please list your work experience beginning with your most recent job held. If you were self-employed, please describe your duties and responsibilities. Attach additional sheets if necessary

May we contact your present employer? Yes N0

Name of Employer

Address

City, State, Zip Code

Phone

Reason for leaving (be specific)

Name of last Supervisor

Employment datesTo:____________ From: ______________

Your last job title:_____________________

__________________________________________________________________________

Name of Employer

Address

City, State, Zip Code

Phone

Reason for leaving (be specific)

Name of last Supervisor

Employment datesTo:____________ From: ______________

Your last job title:_____________________

__________________________________________________________________________

WORK EXPERIENCE

Name of Employer

Address

City, State, Zip Code

Phone

Reason for leaving (be specific)

Name of last Supervisor

Employment datesTo:_____________ From: ______________

Your last job title:______________________

__________________________________________________________________________

LIST REFERENCES (PREFERABLY PERSONS WHO KNOW YOUR WORK/TRAINING)

NAME ADDRESS PHONE NUMBER

___________________________________________________________________________

ADDITIONAL INFORMATION / SKILLS THAT COULD HELP YOU QUALIFY FOR THIS POSITION______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

WORK EXPERIENCE CONTINUED

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

_________________________________________ ____________________________Signature Date

READ CAREFULLY

By signing this application, I certify that all information given in this application is complete and accurate.

RELEASE FORM FOR OBTAINING URINE SAMPLE FOR DRUG AND/OR ALCOHOL SCREENING ALONG WITH PERMISSION TO FURNISH THE RESULTS TO CRAIG

BACHMAN IMPORTS, INC.

Offers of employment with CBI for prospective full-time, permanent part-time, and seasonal employees will be conditioned on proper cooperation with and participation in a drug and controlled substance screening test. Applicants are asked to sign this form consenting to a screening test as part of the application process. Failure to sign the consent form will be considered a withdrawal of the application.

Applicants who test positive without a legitimate medical reason will be denied employment. In appropriate circumstances, CBI may, in its sole discretion, authorize a retest. At his/her expense, an applicant may request a second test be performed on positive drug results only, alcohol positives are not eligible for retesting. The retest based on positive drug results willbe performed within three (3) days of the original test and any sample deemed necessary will be decided by CBI, including, but not limited to giving urine, blood, or hair samples may be requested.

I authorize Craig Bachman Imports, Inc., to allow an accredited clinic to take a urine or Breathalyzer sample from me for use in a drug or alcohol screening. I understand why these samples are being requested and I give permission for the results to be sent to CBI HR Department.

__________________________________ ______________________________Name (Please Print) Social Security Number

__________________________________ ______________________________Signature Date

We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, height, weight, or disability. We assure you that your opportunity for employment with us depends solely on your qualifications.

Thank you for completing this application form and for your interest in Craig Bachman Imports

DRUG / ALCOHOL SCREENING CONSENT FORM

By signing this application, I certify that all information given in this application is complete and accurate.

RELEASE FORM FOR OBTAINING URINE SAMPLE FOR DRUG AND/OR ALCOHOL SCREENING ALONG WITH PERMISSION TO FURNISH THE RESULTS TO CRAIG

BACHMAN IMPORTS, INC.

Craig Bachman Imports may obtain information about you from a third party consumer reporting agency for employment purposes. Thus, you may be the subject of a “consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living. These reports may contain information regarding your credit history, criminal history, social security verification, motor vehicle records (“driving records”).

You have the right, upon written request made within a reasonable time, to request whether a consumer report has been run about you and to request a copy of your report. These searches will be conducted by IntelliCorp Records, Inc., 3000 Auburn Drive, Suite 410, Beachwood, Ohio 44122; Tel. No. 1.888.946.8355; www.intellicorp.net.

_________________________________Signature

______________________________ Date

We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, height, weight, or disability. We assure you that your opportunity for employment with us depends solely on your qualifications.

Thank you for completing this application form and for your interest in Craig Bachman Imports

DRUG / ALCOHOL SCREENING CONSENT FORM CONTINUED

By signing this application, I certify that all information given in this application is complete and accurate.