Balise Automotive Group - West Springfield, Massachusetts

<body text="#000000" link="#3399FF" vlink="#000066" alink="#999999" bgcolor="#ffffff" marginheight="0" marginwidth="0" leftmargin="0" topmargin="0"> <center> <table border=0 width=90%> <tr> <td valign=top> <FORM METHOD="POST" ACTION="employment-application.cgi"> <input type=hidden name=dealer_addr value="dsa@dicksmithauto.com"> <h2 align=center>Employment Opportunities</h2> <font size=3>Dick Smith Automotive Group is always looking for qualified personnel to work in our friendly and professional environment. Please take a few minutes to fill out this application form if you would be interested in becoming part of the Dick Smith Automotive Team!</font> <P> <table border=0 width=90% cellspacing=2 cellpadding=4> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Contact Information</b></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Your Name: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="name"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Internet E-Mail: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="email"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Home Phone: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="phone"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Address: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="address1"></td> </tr> <tr> <td valign=top> </td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="address2"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>City: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="city"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>State: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="state"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Zip: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="zip"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Soc. Security #: </font></td> <td valign=top><INPUT TYPE="text" SIZE=30 NAME="soc_security"></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Position Information</b></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Position you are interested in: </font></td> <td valign=top><INPUT NAME="position" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Are you interested in: </font></td> <td valign=top><font size=1> Full Time: <INPUT NAME="fulltime" value="Full Time" TYPE="checkbox"> Part Time: <INPUT NAME="parttime" value="Part Time" TYPE="checkbox"> Temporary: <INPUT NAME="temporary" value="Temporary" TYPE="checkbox"> </font></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What days and hours are you available?: </font></td> <td valign=top><INPUT NAME="daysandhours" SIZE= "30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What pay do you expect?: </font></td> <td valign=top><INPUT NAME="pay" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>When can you start work?: </font></td> <td valign=top><INPUT NAME="available" SIZE="30" TYPE="text"></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Current Status Information</b></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Are you currently laid off of another job and can be called back to work?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="laidoff" value="yes" TYPE="radio">   No:<INPUT NAME="laidoff" value="no" TYPE="radio"> </font></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Are you currently employed? </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="currently_employed" value="yes" TYPE="radio">   No:<INPUT NAME="currently_employed" value="no" TYPE="radio"><br> </tr> <tr> <td valign=top align=right valign=middle><font size=2>If so by whom?: </font></td> <td valign=top><input name="current_employer" type=text size=30></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Do you have any relatives currently working at Dick Smith Automotive Group (will not necessarily disqualify employment)?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="relatives_employed" value="yes" TYPE="radio">   No:<INPUT NAME="relatives_employed" value="no" TYPE="radio"><br> </tr> <tr> <td valign=top align=right valign=middle><font size=2>If yes, please list their names:</font></td> <td valign=top><font size=2>Employee1:</font><br> <input type=text name="relative_employed1" size=30></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Employee2:</font><br> <input type=text name="relative_employed2" size=30></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Employee3:</font><br> <input type=text name="relative_employed3" size=30></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Education Information</b></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Did you graduate High School?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="grad_highschool" value="yes" TYPE="radio">   No:<INPUT NAME="grad_highschool" value="no" TYPE="radio"> </font></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Did you graduate college?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="grad_college" value="yes" TYPE="radio">   No:<INPUT NAME="grad_college" value="no" TYPE="radio"><br> </tr> <tr> <td valign=top align=right valign=middle><font size=2>If so, what college?: </font></td> <td valign=top><input name="college_name" type=text size=30></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>If you didn't graduate college, how many years did you attend?: </font></td> <td valign=top> <table border=0> <tr> <td align=right><font size=1>1 Year: </font></td> <td><INPUT NAME= "somecollege" value="1" TYPE="radio"></td> <td align=right><font size=1>2 Years: </font></td> <td><INPUT NAME= "somecollege" value="2" TYPE="radio"></td> </tr> <tr> <td align=right><font size=1>3 Years: </font></td> <td><INPUT NAME= "somecollege" value="3" TYPE="radio"></td> <td align=right><font size=1>4 Years: </font></td> <td><INPUT NAME= "somecollege" value="4" TYPE="radio"></td> </tr> <tr> <td align=right colspan=4><font size=1>More than 4 Years: </font> <INPUT NAME= "somecollege" value="4+" TYPE="radio"></td> </tr> </table> </td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Did you attend a technical college?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="attend_techschool" value="yes" TYPE="radio">   No:<INPUT NAME="attend_techschool" value="no" TYPE="radio"><br> </tr> <tr> <td valign=top align=right valign=middle><font size=2>If so, what school?: </font></td> <td valign=top><input name="techschool_name" type=text size=30></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Please list any licenses or certificates relative to employment with Dick Smith Automotive Group?: </td> <td valign=top><font size=2>License1:<br></font><INPUT NAME="licenses1" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>License2:<br></font><INPUT NAME="licenses2" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>License3:<br></font><INPUT NAME="licenses3" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>List job-related professional or technical organizations to which you belong: </td> <td valign=top><font size=2>Organization1:<br></font><INPUT NAME="org1" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Organization2:<br></font><INPUT NAME="org2" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Organization3:<br></font><INPUT NAME="org3" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>List Equipment you can operate relative to the job you are applying for: </font></td> <td valign=top><font size=2>Equipment1:<br></font><INPUT NAME="equip1" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Equipment2:<br></font><INPUT NAME="equip2" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top> </td> <td valign=top><font size=2>Equipment3:<br></font><INPUT NAME="equip3" SIZE="30" TYPE="text"></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>General Information</b></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What do you expect to be doing in 5 years?: </font></td> <td valign=top><textarea NAME="meinfive" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Based on today's prices and wages, what monthly income do you expect to be earning in 5 years?: </font></td> <td valign=top><INPUT NAME="moneyinfive" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What has been your most interesting work? </font></td> <td valign=top><textarea NAME="interesting_work" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What made it so interesting? </font></td> <td valign=top><textarea NAME="interestingwork_why" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>What work experience did you dislike most? </font></td> <td valign=top><textarea NAME="hatedwork" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Why did you dislike it? </font></td> <td valign=top><textarea NAME="hatedwork_why" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Have you ever been convicted of a felony?: </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="felonies" value="yes" TYPE=radio>   No:<INPUT NAME="felonies" value="no" TYPE=radio> </font></td> </tr> <tr> <td valign=top align=right><font size=2>If yes, explain. (Conviction will not necessarily disqualify.) </font></td> <td valign=top><textarea NAME="felony_explain" cols="30" rows="5" wrap=virtual></textarea></td> </tr> <tr> <td valign=top align=right valign=middle><font size=2>Can you, if employed, submit verification of your right to work in the United States? </font></td> <td valign=top><font size=2>   Yes:<INPUT NAME="workvarification" value="yes" TYPE=radio>   No:<INPUT NAME="workvarification" value="no" TYPE=radio> </font></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Employment History - Position 1</b></td> </tr> <tr> <td valign=top colspan=2><center><font size=2>List Present and Past Employers, <b>MOST RECENT FIRST</b>. Personal references may be listed following employment history, please no relatives.</font></center></td> </tr> </table> <table border=0 width=90%> <tr> <td valign=top align=right><font size=2>Employer: </font></td> <td valign=top><input type=text NAME="job1employer" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Address: </font></td> <td valign=top><input type=text NAME="job1address1" size=30></td> </tr> <tr> <td valign=top align=right> </td> <td valign=top><input type=text NAME="job1address2" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Phone: </font></td> <td valign=top><input type=text NAME="job1phone" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Fax: <font></td> <td valign=top><input type=text NAME="job1fax" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Position: </font></td> <td valign=top><INPUT NAME="job1position" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Start Date: </font></td> <td valign=top><INPUT NAME="job1startdate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Termination Date: </font></td> <td valign=top><INPUT NAME="job1enddate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Supervisor: </font></td> <td valign=top><INPUT NAME="job1supervisor" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Starting Salary: </font></td> <td valign=top><INPUT NAME="job1salary_start" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Ending Salary: </font></td> <td valign=top><INPUT NAME="job1salary_ending" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top colspan=2><font size=2>Duties:</font><br><TEXTAREA NAME="job1_duties" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Reason for leaving:</font><br><TEXTAREA NAME="job1leavingreason" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Additional Comments:</font><br><TEXTAREA NAME="job1comments" ROWS="4" COLS="50" wrap=virtual></TEXTAREA><br clear=all><br></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Employment History - Position 2</b></td> </tr>  </table> <table border=0 width=90%> <tr> <td valign=top align=right><font size=2>Employer: </font></td> <td valign=top><input type=text NAME="job2employer" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Address: </font></td> <td valign=top><input type=text NAME="job2address1" size=30></td> </tr> <tr> <td valign=top align=right> </td> <td valign=top><input type=text NAME="job2address2" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Phone: </font></td> <td valign=top><input type=text NAME="job2phone" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Fax: <font></td> <td valign=top><input type=text NAME="job2fax" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Position: </font></td> <td valign=top><INPUT NAME="job2position" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Start Date: </font></td> <td valign=top><INPUT NAME="job2startdate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Termination Date: </font></td> <td valign=top><INPUT NAME="job2enddate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Supervisor: </font></td> <td valign=top><INPUT NAME="job2supervisor" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Starting Salary: </font></td> <td valign=top><INPUT NAME="job2salary_start" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Ending Salary: </font></td> <td valign=top><INPUT NAME="job2salary_ending" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top colspan=2><font size=2>Duties:</font><br><TEXTAREA NAME="job2_duties" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Reason for leaving:</font><br><TEXTAREA NAME="job2leavingreason" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Additional Comments:</font><br><TEXTAREA NAME="job2comments" ROWS="4" COLS="50" wrap=virtual></TEXTAREA><br clear=all><br></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Employment History - Position 3</b></td> </tr>  </table> <table border=0 width=90%> <tr> <td valign=top align=right><font size=2>Employer: </font></td> <td valign=top><input type=text NAME="job3employer" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Address: </font></td> <td valign=top><input type=text NAME="job3address1" size=30></td> </tr> <tr> <td valign=top align=right> </td> <td valign=top><input type=text NAME="job3address2" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Phone: </font></td> <td valign=top><input type=text NAME="job3phone" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Fax: <font></td> <td valign=top><input type=text NAME="job3fax" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Position: </font></td> <td valign=top><INPUT NAME="job3position" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Start Date: </font></td> <td valign=top><INPUT NAME="job3startdate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Termination Date: </font></td> <td valign=top><INPUT NAME="job3enddate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Supervisor: </font></td> <td valign=top><INPUT NAME="job3supervisor" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Starting Salary: </font></td> <td valign=top><INPUT NAME="job3salary_start" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Ending Salary: </font></td> <td valign=top><INPUT NAME="job3salary_ending" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top colspan=2><font size=2>Duties:</font><br><TEXTAREA NAME="job3_duties" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Reason for leaving:</font><br><TEXTAREA NAME="job3leavingreason" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Additional Comments:</font><br><TEXTAREA NAME="job3comments" ROWS="4" COLS="50" wrap=virtual></TEXTAREA><br clear=all><br></td> </tr> <tr> <td colspan=2 valign=top align=center bgcolor="#CDCDCD"><b>Employment History - Position 4</b></td> </tr>  </table> <table border=0 width=90%> <tr> <td valign=top align=right><font size=2>Employer: </font></td> <td valign=top><input type=text NAME="job4employer" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Address: </font></td> <td valign=top><input type=text NAME="job4address1" size=30></td> </tr> <tr> <td valign=top align=right> </td> <td valign=top><input type=text NAME="job4address2" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Phone: </font></td> <td valign=top><input type=text NAME="job4phone" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Fax: <font></td> <td valign=top><input type=text NAME="job4fax" size=30></td> </tr> <tr> <td valign=top align=right><font size=2>Position: </font></td> <td valign=top><INPUT NAME="job4position" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Start Date: </font></td> <td valign=top><INPUT NAME="job4startdate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Termination Date: </font></td> <td valign=top><INPUT NAME="job4enddate" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Supervisor: </font></td> <td valign=top><INPUT NAME="job4supervisor" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Starting Salary: </font></td> <td valign=top><INPUT NAME="job4salary_start" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top align=right><font size=2>Ending Salary: </font></td> <td valign=top><INPUT NAME="job4salary_ending" SIZE="30" TYPE="text"></td> </tr> <tr> <td valign=top colspan=2><font size=2>Duties:</font><br><TEXTAREA NAME="job4_duties" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Reason for leaving:</font><br><TEXTAREA NAME="job4leavingreason" ROWS="4" COLS="50" wrap=virtual></TEXTAREA></td> </tr> <tr> <td valign=top colspan=2><font size=2>Additional Comments:</font><br><TEXTAREA NAME="job4comments" ROWS="4" COLS="50" wrap=virtual></TEXTAREA><br clear=all><br></td> </tr> </table> <P> <dl> <dt> <FONT SIZE=1>By sending in this E-mail form, I certify that all information submitted in this application form, or in any resume, interview, or other information, is true and complete and that I have not knowingly withheld, nor will I withhold, any information that would affect my application for employment.</FONT> <P><FONT SIZE=1>I understand that employer is under no obligation to consider or reconsider this application at any time, and that acceptance of my application does not constitute an offer of employment. I also understand and agree that:</FONT> </dt> <dd> <FONT SIZE=1>1. Inquiries may be made with my previous employers or others who I may have knowledge of m, or with consumer credit, investigative, or other private or governmental agencies. I authorize any such person or agency to give you any and all information concerning my previous employment, including but not limited to, an assesmen of my job performance, ability, and fitness, and/or any other information they may have, personal or otherwise, and release all parties from any and all liability, claims, or damages that they may directly ot indirectly result from furnishing same. Upon my reasonable and timely request, a description of the general scope and nature of any such inquiry will be provided to me.</FONT> <P><FONT SIZE=1>2. Prior to my beginning work or during my employment, employer reserves the right to require ant lawful form of medical, drug, alcohol, psychological, character, honesty, integrity, aptitude, skill, or other test or examination.</FONT> </dd> </dl> <p>  <center> <INPUT TYPE="submit" VALUE="Submit Application">   <input type="reset" value="Clear Application"> </center> </FORM> </td> </tr> </table> </center> </font>  </font> </td> </tr> <tr> <td width=100% align=center valign=bottom> <table width=100% cellspacing=0 cellpadding=0 border=0> <tr> <td valign=top align=left><font size=2> </font></td> <td valign=top align=right><font size=2> </font></td> </tr> </table> </td> </tr> </table>  </body></html>