do┬┤ West Springfield Auto Parts
 
  West Springfield Auto Parts Inc. (WSAPARTS) is an Equal Opportunity Employment and Affirmative Action Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.
PLEASE TYPE OR PRINT. Complete the entire application. You may attach a resume, but you must still complete all questions or your application will be deemed incomplete and may not be considered. Please fill out each box (don't just indicate "See Resume").
Position Applying For:
Name (Last, First, Middle):
Street Address:
City, State & Zip:
Other names under which you have attended school or been employed:
Social Security Number:
Home Phone:
Work Phone:
Other Phone:
Are you eligible to work in the United States? Yes   No  
Are you 18 years of age or older? Yes   No  
Are you currently employed? Yes   No If YES, what is your current job title & department?
Have you ever been employed by WSAPARTS? Yes   No If YES, dates of employment & reason for leaving:
Are you related to any current WSAPARTS employee? Yes   No If YES, their name & their relationship to you?
If required for position, do you have a valid driver's license? Yes   No If YES, State of issuance, license #, and expiration date:
** IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITY. **

MILITARY
Did you serve in the U.S. Armed Forces? Yes   No If YES, in which Branch?
US Air Force US Army US Coast Guard
US Marines US Navy National Guard or Reserve Unit
Other
Describe any training received relevant to the position to which you are applying:

EDUCATION
Name of School Did you graduate? If No, # of years left to graduate If Yes, date of Graduation Degree received Major
High School: Yes   No
GED: Yes   No
Other School: Yes   No
College: Yes   No
College: Yes   No
Other training/credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.

SKILLS: Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)

WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE NOTE: WSAPARTS reserves the right to contact all current and former employers for reference information.
Dates Employed (most recent position) From: To Full Time   Part time.
If part-time, # hrs./wk
Title:
Starting Salary:

Final Salary:
Organization Name:

Organization Address:

Supervisor's Name, Title and Phone#:
Other Reference Name, Title and Phone #: Contact my current references:
At any time
Only if I am a finalist candidate
DO NOT CONTACT AT THIS TIME.
Primary duties:
Dates Employed From: To Full Time   Part time.
If part-time, # hrs./wk
Title:
Starting Salary:

Final Salary:
Organization Name:

Organization Address:

Supervisor's Name, Title and Phone#:
Other Reference Name, Title and Phone #: Contact my current references:
At any time
Only if I am a finalist candidate
DO NOT CONTACT AT THIS TIME.
Primary duties:
Reason for Leaving:

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize WSAPARTS to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this Application for Employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of WSAPARTS serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States and to comply with Company and departmental regulations. Applicants for driving positions hereby authorize WSAPARTS to obtain and review their Department (Registry) of Motor Vehicles driving record. This authorization will continue annually, while employed with the Company.

Applicant Signature:       Date:       

(Type Name in Full to represent your signature)