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Non-Driver Application

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Applicant Information

Full Name*

First Middle Last

Phone*

Email*

Current Address*

Street Address Address Line 2 City State ZIP Code

Employment Desired

Desired Position*

Desired Salary*

Date Available for Work*

Month

Day

Year

Are you employed now?*

Yes

Do you have the legal right to work in the United States?*

Yes

Have you ever been employed by this organization before?*

Yes

If yes, list dates of employment*

Industry Experience

Industry Experience*

Summarize any industry experience that you may have that would be relevant to this position, or any other relevant skills you possess.

Employment History

Current (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

Do you need to list another (second) employer?*

Yes

Second (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

Do you need to list another (third) employer?*

Yes

Third (Most Recent) Employer

Company Name*

Phone

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary

Dates Employed*

From

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

Do you need to list another (fourth) employer?*

Yes

Fourth (Most Recent) Employer

Company Name*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisors Name & Title*

Position Held*

Salary*

Dates Employed*

From

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

Yes

Education

List of Education History*

Please enter each school that you attended, including high school, college, and trade schools if applicable. (Click the + button to add a new row)

School Name

Address

Years Attended

Did You Graduate?

Subjects Studies

Other Qualifications*

Please list any other qualifications which you have and which you believe would be important for consideration by the company pertaining to this application.

References

Please provide the Name, address, and telephone of four references who are not related to you and you have known for at least five years.

Reference 1*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 2*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 3*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Reference 4*

Name

Relationship

Company

Years Acquainted

Address

Phone Number

Acknowledgement

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

Prospective applicants will receive consideration without discrimination because of race, color, religion, sex, national origin, age, marital or veteran status, non-job-related medical conditions or handicaps, or any other legally-protected status.

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

Signature*

Full Name*

Date*

MM slash DD slash YYYY

Resume/File Upload (optional)

If you have a resume or additional documents you would like to attach, please do so here. This is not required.

Drop files here or

Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf, Max. file size: 5 MB, Max. files: 5.

Your information is processed securely, and is never shared, distributed, or sold to any third parties. By providing a telephone number and submitting the form you are consenting to be contacted by voice or SMS text message. Message frequency may vary. Message & data rates may apply. Reply STOP to opt-out, Reply HELP for more information.

Office & Storage Yard
850 33rd St W, Palmetto, FL 34221
24/7 Service

Office, Repair Shop, & Storage Yard
5911 17th St E, Bradenton, FL 34203
M-F: 9am-5pm
Saturdays: 10am-3pm
Sunday: Closed

Call 855-941-8697

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We are proud to give back to those who dedicate their lives to serving our community and our country. To show our appreciation, we offer special discounts to active duty military and veterans, as well as our local first responders, including firefighters, EMTs, and police officers. We also extend these savings to healthcare professionals, government employees, and teachers in recognition of their essential work. It is our way of saying thank you to the heroes in Palmetto, Bradenton, and beyond who make our community a better place to live.

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