Personal Information Name* Address* Email* *Note: A valid Social Security number must be provided upon being offered a position at Clear Water Car Wash. Have you previously been employed with Clear Water Car Wash?* Yes No Availability Position Applying For* Full-time Part-time Seasonal Temporary Desired Hourly Pay* Available Start Date* Are you available for overtime?* Yes No Are you available for weekend work?* Yes No Education History High School Did You Graduate?* Yes No College Trade, Business or Correspondence School Did You Graduate? Yes No Employment History Employer* Address* Phone Number* Supervisor* Job Title* Type of Position* Full-time Part-time Seasonal Temporary Time Employed* Hourly Rate or Salary* May we contact this employer for reference?* Yes No Employment History Continued Employer Address Phone Number Supervisor Job Title Type of Position Full-time Part-time Seasonal Temporary Time Employed Hourly Rate or Salary May we contact this employer for reference? Yes No Additional Information Do you have a valid Driver's License?* Yes No Do you have reliable transportation?* Yes No Can you drive a manual transmission vehicle?* Yes No If you are under 18 years of age, can you provide a work permit? Yes No References Please list three (3) employment or personal references. Do not list relatives. Reference 1* Reference 2* Reference 3* Certification I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my pervious employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability related or medical information in a manner prohibited by the Americans of Disabilities Act (ADA) and other relevant federal and state laws.” I understand and agree to the above disclosure statement * By typing my name, I am electronically signing my application.