Instructions: PLEASE READ CAREFULLY


All requested information must be furnished. Fill in all spaces accurately and completely. If an item does not
apply to you, or if there is no information to be given, write in the letters "N/A" for "not applicable". Documents
submitted with the Application will not be returned. All information contained in the application is subject to
verification. Any omissions or erroneous statements may be cause for rejection of this application, removal
from eligibility, or discharge from Burnett Automotive.

 
Date of application:
Position you are applying for:
Name:
Street Address:
City:
State:
Zip Code:
Home phone:
Cell phone:
Email (optional):
 
Have you ever been employed by Burnett Automotive?:
If YES:
Which Location:		    
Position held:
Dates:    
May we contact your current or previous employers?:
If NO, please explain:
   
If less than 18 years of age, can you provide proof of eligibility to work?  
(Applicants less than 18 years of age may be required to provide proof of age.)  
   
Do you have a valid driver's license?  
State:    
License Number:    
Expiration Date:    
       
Note: Burnett Automotive will make a motor vehicle operation history inquiry. A poor-driving record may
disqualify an applicant from consideration for the position. By submitting this application, you specifically
authorize Burnett Automotive to make an inquiry of your driving record.
       
Have you been convicted of a felony within the last 5 years?  

if YES, explain where, when, and reason.
(Conviction will not effect employment decisions unless it specifically relates to the fitness to perform the position.)
       
If employed, can you provide proof of U.S. citizenship, immigration, or visa status,
which permits you to be employed in the U.S.?
(Proof of citizenship or immigration status will be required upon employment.)  
   
On what date are you available for work?  
Are you available to work:  
Are you on lay-off and subject to recall?  
If YES, explain:
 
EDUCATION
High School: Name and Location:
  Type of Cert / degree:
  Date Received:
  Course of study / major:
     
College Name and Location:
  Type of Cert / degree:
  Date Received:
  Course of study / major:
     
Graduate School Name and Location:
  Type of Cert / degree:
  Date Received:
  Course of study / major:
     

Business/
Trade School:

 Name and Location:
  Type of Cert / degree:
  Date Received:
  Course of study /major:
     
List any licenses, professions registrations, honors, awards, or fellowships:
       
Specialized Skills:    
 
MILITARY SERVICE
Have you served in the U.S. Armed Forces? If Yes, Dates: From:
Branch of Service:  
Special Training:  
Specific Duties:    
     
Give name, address and telephone number of three references. Individuals given as references should
not be related to you and should not be previous employers.
Name:    
Address:    
Phone:    
       
Name:    
Address:    
Phone:    
       
Name:    
Address:    
Phone:    
 
State any additional information you feel may be helpful to us in considering your application:
 
EXPERIENCE
Beginning with your present job (or immediate past job if unemployed) please provide the following
information for the last 10 years, including periods of unemployment and the reasons for the
unemployment. IT IS CRITICAL THAT YOU PROVIDE COMPLETE INFORMATION.
       
Job Title: From:
Employer Name Salary $ per
Address: Phone:
Supervisor's name and title:
Duties:  
Reason for leaving:
 
Job Title: From:
Employer Name Salary $ per
Address: Phone:
Supervisor's name and title:
Duties:  
Reason for leaving:
 
Job Title: From:
Employer Name Salary $ per
Address: Phone:
Supervisor's name and title:
Duties:  
Reason for leaving:
 
 
We are an Equal Opportunity Employer, in compliance with all federal and state laws. This organization is
committed to the policy of equal employment opportunity in recruitment, hiring, career advancement, and
all other personnel practices. Your job related experience and other qualifications will be considered without
discrimination on grounds of race, sex, disability, religion, age, color, national origin or ancestry, or other
factors that cannot be lawfully used as a basis for an employment decisions. All other information provided
in this application will be treated confidentially, and if employed, will be used only to help assure the best
use of your abilities.

IMPORTANT: READ CAREFULLY. When you have submitted your completed application you will be forwarded
to a “Job Fit Assessment” survey. This MUST be completed for your application to be considered. If you are not
forwarded to that page, or have other problems you can take the Job Fit Assessment by going to:
www.candidatelink.com/burnett.

The assessment is in three parts: 1) Basic Information; 2) the Job Fit Assessment survey; and 3) a Cognitive Assessment.
Note that the cognitive assessment is timed and you only have 6 minutes to complete it. This survey is designed to detect inconsistencies which reflect in both character and aptitude, so be honest and try not to"over think" your answer.