Employment Application

PERSONAL INFORMATION

First Name(Required)

Middle Name

Last Name(Required)

Date

MM slash DD slash YYYY

Social Security Number

Present Address

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone Number(Required)

Are you 18 years or older?

Are you prevented from lawfully becoming employed in this country because of Visa or immigration status?

Have you ever been convicted of a crime?

Do you possess a valid driver's license?

Do you possess a valid CDL?

This section to be completed by ALL applicants:

Drivers License Number & State of Issuance

Date of Birth

MM slash DD slash YYYY

EMPLOYMENT DESIRED

Position(Required)

Other Position (not listed)

Date you can start

MM slash DD slash YYYY

Salary Desired

Shift Preference

If applying for a service technician position, do you have your own tools?

Are you employed now?

If yes, with whom?

If so, may we inquire of your present employer?

Ever applied to this company before?

Where?

When?

EDUCATION

Grammar School

Name and Location of School

No. of Years Attended

Did you Graduate?

Subjects Studied

High School

Name and Location of School

No. of Years Attended

Did you Graduate?

Subjects Studied

College

Name and Location of School

No. of Years Attended

Did you Graduate?

Subjects Studied

Trade or Business School

Name and Location of School

No. of Years Attended

Did you Graduate?

Subjects Studied

GENERAL

Describe any specialized training, apprenticeships, certifications, licenses, or skills:

Have you received any job-related training in the United States Military or Naval Academy?

If so, please provide dates and describe

FORMER EMPLOYERS (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)

From - To

Date (Month and Year)

Name and City of Employer

Salary

Position

Reason for Leaving

Explain any periods of unemployment between positions:

Which of these jobs did you like best and why?

FORMER SUPERVISORS

LIST THE SUPERVISORS YOU WORKED FOR AT THE JOBS ABOVE

Name

Business

Telephone

In case of emergency notify:

Telephone

Address

I certify that all of the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

Signature(Required)

Date

MM slash DD slash YYYY

AUTHORIZATION AND RELEASE

In consideration of the agreement by Lakeside International Trucks to receive and consider my application for employment, I hereby authorize, consent and grant the privilege to Lakeside and its agents to review and examine any public or private records pertaining to my educational, personal and credit history, driver's license verification & driving history, and criminal conviction history. I expressly release Lakeside International and its agents from liability whatsoever arising out of such investigation. All information will be kept confidential by Lakeside International Trucks and is used only by the Human Resources Department.

Have you used any other name than the one provided above?(Required)

If yes, list other names and dates of use:

Previous Address (if lived in above address for less than 7 years)

By signing below, I agree to the above authorization and release statement.

Date

MM slash DD slash YYYY

NOTE: THIS FORM GOES DIRECTLY TO HUMAN RESOURCES

SELF IDENTIFICATION FORM

Lakeside International Trucks has adopted an Affirmative Action Ordnance and the following information is voluntary and allows us to meet government-reporting requirements and evaluate the effectiveness of our recruitment efforts. The information will be kept confidential and when reported, data will not identify any specific individual. Refusal to provide this information will not subject you to any adverse treatment in accordance with any of Lakeside International Trucks' policies and ordinances, which forbids discrimination-based on this information.

VETERAN STATUS: (Please check one)

Non Veteran

Veteran (DD214 From must be attached)

Veteran claiming disability (DD214 Form and Veterans Disability Form must be attached)

Other (specify service dates)

Other:

ETHNICITY: (SELECT ONE)

Hispanic or Latino (Person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race)

Not Hispanic or Latino

RACE: (SELECT ONE OR MORE)

American Indian or Alaskan Native — A Person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.

Asian —A Person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American — A Person having origins in any of the Black racial groups of North Africa.

Native Hawaiian or Other Pacific Islander — A Person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White — Person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

GENDER:

DATE OF BIRTH:

MM slash DD slash YYYY

SOCIAL SECURITY NUMBER:

If you should become a finalist in the hiring process, Lakeside International Trucks will require your date of birth. This information is intended for the sole use of a background investigation process for candidates. The provision of your social security number is not mandatory. It will be used only for applicant tracking purposes. If you choose not to provide your SS# at this time, the Human Resources Department will provide you an arbitrary nine-digit number.

DISABILITY: Do you have a disability?

Lakeside International Trucks considers a person with a disability anyone who meets the definition under either the American With Disabilities Act or the Wisconsin Fair Employment Act. You may contact the Occupational Accommodations Specialist at the number listed below if you need additional information. If you need reasonable accommodation(s) during the application process due to disability related functional limitations, please notify Lakeside International Trucks Human Resource Department at (414) 353-4800.

I need an accommodation in the hiring/ examination process:

If yes, accommodation requested is (i.e., extended time, reader, alternative test format, other):

**You will be required to provide written verification from a doctor or other authorized person confirming your disability and indicating reasonable accommodation.

How did you learn of this position? Please choose all that apply(Required)

Referral (Employee, Friend, Family)

Facebook or Other Social Media

Online/Internet Ad

Indeed

Zip Recruiter

Other Job Board

Recruiter

Lakeside website

Referred by:

Other:

DEPARTMENT

INVENTORY

SHOWROOM

OTHER RESOURCES

Employment Application