Step 1 of 5

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• Personal Information

• Name*
  
  First Name
  
  Last
• Email*
  
• Phone*
• Address*
  
  Street Address
  
  City
  StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
  State
  
  ZIP Code
  

• Employment Details

• LOCATION APPLYING TO*Choose location…LouisvilleLoveland
• TYPE OF EMPLOYMENT DESIRED*Choose…Full TimePart Time
• ARE YOU FLUENT IN SPANISH?*
  • 
    Yes
  • 
    No
• DO YOU HAVE RELIABLE TRANSPORTATION TO WORK?*
  • 
    Yes
  • 
    No
• Weekly Availability
  Please fill out your availability for each day of the week to the nearest half hour. Shifts begin at 7:00am and end as late as 7:00pm(Loveland) and 8pm(Louisville). If unavailable on a particular day, please enter “N/A” for that day.

  Example:
  6:00am-9:00am
  8:30am-4:30pm
  12:00pm-7:30pm

• MONDAY*
• TUESDAY*
• WEDNESDAY*
• THURSDAY*
• FRIDAY*
• SATURDAY*
• SUNDAY*
• Why would you like to work at Speedy Sparkle?
• Describe yourself in three words.
• What do you like to do for fun?
• Please describe a situation that demonstrates excellent customer service.

• High School Education

• SCHOOL NAME
• YEAR OF GRADUATION

• College / Post High School Education

• SCHOOL NAME
• MAJOR OR AREA OF INTEREST
• YEARS ATTENDED OR DEGREE ACHIEVED

• Military Experience

• BRANCH OF MILITARY
• AREA OF WORK/INTEREST

• Previous Employment

• COMPANY NAME
• POSITION HELD
• DATES EMPLOYED FROM/TO
• Address
  
  Street Address
  
  City
  AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
  State
  
  ZIP Code
  
• RESPONSIBILITIES/DUTIES
• STARTING SALARY & POSITION TITLE
• ENDING SALARY & POSITION TITLE (IF DIFFERENT)
• REASON FOR LEAVING
• DIRECT SUPERVISOR / EMPLOYER NAME
• DIRECT SUPERVISOR / EMPLOYER NAME PHONE
• MAY WE CONTACT THIS EMPLOYER FOR A REFERENCE?
  • 
    Yes
  • 
    No
• Add New previous
  • 
    ADD ANOTHER PREVIOUS EMPLOYER

• Previous Employment 2

• COMPANY NAME
• POSITION HELD
• DATES EMPLOYED FROM/TO
• Address
  
  Street Address
  
  City
  AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
  State
  
  ZIP Code
  
• RESPONSIBILITIES/DUTIES
• STARTING SALARY & POSITION TITLE
• ENDING SALARY & POSITION TITLE (IF DIFFERENT)
• REASON FOR LEAVING
• DIRECT SUPERVISOR / EMPLOYER NAME
• DIRECT SUPERVISOR / EMPLOYER NAME PHONE
• MAY WE CONTACT THIS EMPLOYER FOR A REFERENCE?
  • 
    Yes
  • 
    No
• Previous
  • 
    ADD ANOTHER PREVIOUS EMPLOYER

• Previous Employment 3

• COMPANY NAME
• POSITION HELD
• DATES EMPLOYED FROM/TO
• Address
  
  Street Address
  
  City
  AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
  State
  
  ZIP Code
  
• RESPONSIBILITIES/DUTIES
• STARTING SALARY & POSITION TITLE
• ENDING SALARY & POSITION TITLE (IF DIFFERENT)
• REASON FOR LEAVING
• DIRECT SUPERVISOR / EMPLOYER NAME
• DIRECT SUPERVISOR / EMPLOYER NAME PHONE
• MAY WE CONTACT THIS EMPLOYER FOR A REFERENCE?
  • 
    Yes
  • 
    No

• Disclaimer

  I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. By submitting this form to Speedy Sparkle Car Wash is accepting this as your e-signature for this employment application.

• NAME / SIGNATURE:*
• Date*
  
  MM slash DD slash YYYY