Application for Independent Contractor
Full Name:
Social Security No.
Address:
             City:
State:
    ZIP Code :
Home Telephone:
Cell Phone:  
Email Address :
Date of Birth:
  
Driver's License No.
How is your driving
record? Describe:
Can you drive a stick shift?
Have you ever been
convicted of a felony?
Availability:
From:
To:
Please specify AM or PM.
MON TUE WED THUR FRI SAT SUN
Date you can start:
Education:
High School:
College:
Other:
School Name & Location Years Attended Did you Graduate?
 
Date (From/To):
Employer Name & Address:
Salary:
Reason for Leaving:
PREVIOUS EMPLOYMENT:
Position:
 
Date (From/To):
Employer Name & Address:
Salary:
Reason for Leaving:
PREVIOUS EMPLOYMENT 2:
 
Position:
 
Date (From/To):
Employer Name & Address:
Salary:
Reason for Leaving:
PREVIOUS EMPLOYMENT 3:
 
Position:


What (if any) career goals have you set for yourself in the future? ( i.e. what do you want to be doing in the next ten years from now?)

PLEASE ANSWER THE FOLLOWING QUESTIONS OPENLY AND HONESTLY

 
What are you looking for as an A-1 Valet associate?
What do you expect from this company &
it's administrative team?
 
Since the valet of cars is a service business, it is based in part on the acquisition of tips, please expand on this statement
 
Please express any concerns you may have with A-1 Valet Inc.

A-1 Valet Inc. is an equal opportunity employer.