Address:  City State:  Zipcode:

Phone Number XXX/XXX-XXXX FORMAT       EMAIL:

Birthdate: xx/xx/xxxx    Social Security Number:

Are you a U.S. citizen?   Yes   No

Have you ever worked for Monroe Supply, Monroe Custom Campers, or Monroe Truck and Auto Accessories? (type YES or NO)

If you have please list the dates:     Do you have any family or friends that work for us?

Have you ever been convicted of a Felony? (type YES or NO)

IF YES what are you convicted of?

Have you ever worked for a previous truck and auto accessories company? (YES or NO)

Please tell us about your previous employment and/or current employment.  Please list dates.

Please tell us where you worked, your positions held, job duties and responsibilites, dates including month and year, and phone number with your previous or current supervisor. Any gaps in dates will be questioned.

Why did you leave your last job?

Please list all experiences and skills that you have that you may feel are necessary for the job:

Please List THREE references:

Are you a patient person? YES or No

Do you get along well with others?

WARNING!!! PLEASE PRESS THE SUBMIT BOTTON ONLY ONCE!