Online Job Application

Complete all areas of this form and click submit.

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Home Phone:

Cell or Work Phone:

May we contact you at work?

yes
no

Are you eligible to work in the United States?

yes
no

Are you 18 or older?

yes
no

Position Applying For:

Work status preference:

Full Time
Part Time
Temporary

If offered employment when would you be able to start?

Desired Hourly Rate or Pay Range:

Have you ever been employed by Great Lakes Quick Lube?

yes
no

If yes, list positions held and approximate dates worked:

If you have relatives employed by Great Lakes Quick Lube, list their names and positions:

If position requires, are you willing to travel?

yes
no

Are there any limitations on your ability for work or overtime? If yes, please explain:

Have you ever been convicted of a crime?

yes
no

If yes, state date, place and nature of conviction*

*A criminal record does not constitute an automatic bar to employment. It will be considered only if it substantially relates to the job for which you are applying for.

Have you ever been discharged or asked to resign from any position?

yes
no

If yes, please explain:

Employment Experience:

Start with present or last job and leave no gaps.

Employer Name, Address and Phone Number:

Start Date:

End Date:

Starting/Present Job Title

Starting Salary/hourly rate:

Ending Salary/hourly rate:

Supervisor:

May we contact?

yes
no

Reason for leaving:

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Employer Name, Address and Phone Number:

Start Date:

End Date:

Starting/Present Job Title:

Starting Salary/hourly rate:

Ending Salary/hourly rate:

Supervisor:

May we contact?

yes
no

Reason for leaving:

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Employer Name, Address and Phone Number:

Start Date:

End Date:

Starting/Present Job Title:

Starting Salary/hourly rate:

Ending Salary/hourly rate:

Supervisor:

May we contact?

yes
no

Reason for leaving?

Qualifications / Skills / Certifications, etc.

Please list job-related qualifications, skills, certifications, training, experiences, etc., you feel qualify you for the position with our company for which you are applying:

Education:

Select highest grade completed:

Name of last school attended:

City/State Location:

Most current degree acheived:

Where obtained:

Cumulative GPA:

Applicant: Read and initial before submitting this application:

Thank you for your interest in employment with Great Lakes Quick Lube, LLP. We comply with all federal, state, and/or local laws that prohibit unlawful discrimination in employment, including those based on race, religion, color, age, sex, national origin, disability, marital status, veteran status or other legally protected characteristics.

If you are hired, you will be required to present evidence of your legal right to work in the United States no later than three (3) days after commencement of your employment.

I certify that all statements and information contained in this application were made by me and are true, correct and complete to the best of my knowledge and beleif. The correctness of all statements made herein may be investigated. I understand that any misstatement or omission of information shall constitute grounds of immediate dismissal or rejection of my application.

I authorize Great Lakes Quick Lube to investigate my responses on this application and to contact all former employers or any individuals familiar with my employment, educational background and me unless so specified otherise within this application form, including educational institutions. Such investigation is for purposes of verifying information I have provided or for obtaining any information -- whether favorable or unfavorable -- about my employment, education or me. I hereby authorize any and all persons and organizations having information pertaining to me and my past and current employment and education to disclose such information to Great Lakes Quick Lube, LLP. in connection with its consideration of this application of employment (and any resulting employment, if applicable) and I voluntarily and knowingly fully release and hold harmless Great Lakes Quick Lube, LLP, and any person or organization that provides information pertaining to me and/or employment, as conditioned by law.

If employed by this organization (Great Lakes Quick Lube, LLP) I agree:

To assign to the organization all inventions relating to the business of the organization or resulting from tasks assigned to me by the organization, which inventions are made by me, alone or jointly with others during such employment or within on year following termination therof.

The confidential information and knowledge I acquire in such employment is to be kept confidential and to be divulged only when authorized by the organization.

All outstanding expenses owed the organization may be deducted from my paycheck and/or from any other amounts owed to me by the organization.

The organization may inspect all personal property brought on to or removed from organization premises at any time without notice.

Employment and conpensation can be terminated without cause and without notice, at any time, at the option of the organization or the employee. I understand that unless such agreement/contract has been executed in writing to me by the President, my employment with Great Lakes Quick Lube is "at-will" and I in no way bind Great Lakes Quick Lube, LLP to a contractual agreement regarding permanency of employment.

I understand that a job offer will be subject to the following:

A physical examination and/or drug screening, if required for the position. Note: If this is a job requirement, you will be notified of this requirement following an offer of employment. Such requirement would have to be successfully completed as a condition of employment.)

Verification of my social security number by the Company using the Social Security Administration's verification system to accurately provide information for tax reporting and other withholding purposes. I understand that a start date may not be determined until such verification is completed.

A Proprietary and Confidentiality Agreement may be required. If such an agreement is required, you will be notified.

Regardless of whether or not I become employed by Great Lakes Quick Lube, LLP, I recognize that this form, Great Lakes Quick Lube, LLP's application process, and any offer of employment should not be considered as a contract of employment. I understand that no person other than the President has the authority to offer any agreement regarding employment or an employment contract.

I AGREE (Type Initials)

By submitting this application, I certify that I have read and understand the information provided above.