HOGAN TIRE E A

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Name (last name, first name) _______________________________________ E-Mail ______________________________________________________

Home Address _____________________________________________ City ________________________ State _________ Zip ______________

Cell Phone (with area code) ______________________________ Home Phone ______________________________

Date available to start ______________________________ Salary Desired _____________________________

Have you ever worked for Hogan Tire? Ÿes¨No If yes, which location and when?_____________________________________________

Are you 18 years or older? Ÿes¨No

Are you legally allowed to work in the United States? Ÿes¨No

Type of employment desired: ¨Full Time ¨Part Time (less than 30 hours per week) ¨Temporary/Seasonal

If the position you are applying for will require you to drive for the company, do you have a valid driver’s license? Ÿes¨No

How were you referred to Hogan Tire? ______________________________________________________________________________________

Have you ever been discharged or asked to resign from any employment? Ÿes¨No

If yes, please explain: _______________________________________________________________________________________________

Attendance and Punctuality: Consistent attendance and punctuality are essential requirements of every job with Hogan Tire.Is there anything that would interfere with your regular attendance and punctuality if you were offered a job with this Company? Ÿes¨No

If yes, please explain: ________________________________________________________________________________________________

EMPLOYMENT APPLICATION 032014

EDUCATION:

Date _____________________ Position(s) applied for ________________________________________________Location (check all locations you applying for): ¨Woburn ¨Westwood ¨Waltham ¨Natick ¨Beverly ¨Lowell ¨Hudson

¨ European tire changer¨ Run flat tire installation¨ Wheel balancer¨ Tire repair - inside patch

¨ Vehicle lift - set up/use¨ TPMS scan tools¨ Wheel alignment machine¨ Oil change experience

¨ Brake service¨ Anti-lock brake service¨ Brake lathe set up/use¨ Chassis/Steering

¨ Exhaust repair¨ Acetylene torch set¨ Engine repair¨ Diagnostic scanner

¨ A/C recharge machine¨ Radiator flush/fill machine¨ Battery Tester/Charger¨ PC - Labor/Technical guides

APPLICANT DATA:

HOGAN TIRE& AUTO SERVICE CENTERS

Did you graduate from high school? Ÿes¨No¨G.E.D.What is the highest elementary, high school or college grade you have completed? __________

No. of Years School Name Location (city and state) Major or course subject GraduatedTrade School: _______ ______________________________ ________________________ ___________________ Ÿes¨NoCollege/University: _______ ______________________________ ________________________ ___________________ Ÿes¨NoOther: _______ ______________________________ ________________________ ___________________ Ÿes¨No

Qualifications:Tire or Auto Technician applicants only: What areas are you competent and experienced in? (check all that apply)

Are you certified in auto repair by ASE or equivalent ? Ÿes¨No If yes, in what area(s)? __________________________________________Are you certified in tire service by T.I.A. or equivalent? Ÿes¨No If yes, what certification do you have? ______________________________Please list other skills or experience to be considered in evaluating your qualifications?

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Begin with your most recent position

1.Dates of Employment: From ________________ To ________________ Position(s) Held ______________________________________

Company _______________________________________________________ City _________________________________ State ____________

Supervisor’s Phone _______________________________ Supervisor _______________________________ Title _________________________

Responsibilities _________________________________________________________________________________________________________

Starting Salary and Position _____________________________________ Ending Salary and Position ___________________________________

Reason for Leaving _____________________________________________________________________________________________________

May we contact this employer? Ÿes¨No If “no” may we contact them upon your acceptance of our employment offer?Ÿes¨No















By signing this application for employment, I certify that I have read and understand all parts of it and certify that I have truthfully and completely answered all questions. Iunderstand that falsification or omission of material information given herein or in any other employment-related form or context is grounds for immediate termination, regardlessof when such falsification may be discovered. I understand that nothing in this application is intended to imply or create an employment contract. I authorize Hogan Tire and itsrepresentatives to investigate my education, employment, experience, felony conviction records and all other aspects of my background relevant to my proposed employment,including all statements made by me in my application for employment. Further, I understand that employment will be contingent upon a successful background check, thesuccessful completion of a pre-employment drug-screening test and a pre-employment physical. I understand and agree that if I am offered employment by Hogan Tire it will beon an at-will basis. This means either Hogan Tire or I may terminate the employment relationship at any time for any reason, with or without cause. This policy of at-will employmentmay be revised, deleted or superseded only by a written employment agreement signed by the employee in question and the President that expressly revises, modifies, deletesor supersedes the policy of at-will employment. If accepting employment with Hogan Tire, I agree to comply with all company policies, procedures and practices which HoganTire may revise, modify in whole or in part at any time and with all laws, rules and regulations during my employment with Hogan Tire.

Signature of Applicant ________________________________________________________ Date____________________

Print name of Applicant ________________________________________________________

Hogan Tire is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, sex, national origin, ancestry, age (over 40), religion,Veteran status, physical or mental disability, as well as any other category protected by federal, state or local laws. This application will remain active for 30 days.After that time, application must be renewed by the applicant if he/she wishes to be reconsidered for employment.

PREVIOUS EMPLOYMENT:

SIGNATURE:

Ed H

Typewritten Text

For electronic applications you will be required to enter a digital signature which will be binding as your actual signature. Your electronic signature above indicates your agreement with the terms of this application.

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HOGAN TIRE E A