EmailMe Form - RENT-N-ROLL Application For Employment

Position(s) Applied For *

Equal access to programs, services and employment is available to all persons. Those applicants requiring accommodation to the application and/or interview process should contact a representative if the Human Resources Department.

Location Available To Work *

Marion OH

Delaware OH

Are you willing to relocate? *

Yes

No

Full Name *

First Middle Last Suffix

Address 1 *

Address 2

City *

State *

Zip Code *

Home Phone

### - ### - ####

Mobile Phone

### - ### - ####

Email Address *

Social Security Number *

Enter SSN as 123456789 (no dashes)

Please Answer The Following:

Are you 18 years old or older? *

Yes

No

Have you ever applied to Buckeye Wheel and Tire before?* *

Yes

No

Have you ever been employed by Buckeye Wheel and Tire before?** *

Yes

No

Are you legally eligible for employment in this country? (proof of U.S. citizenship will be required upon employment) *

Yes

No

Are you on layoff and subject to recall?*** *

Yes

No

Are you able to meet attendance requirements? *

Yes

No

Will you work overtime if required? *

Yes

No

Have you been convicted of a felony in the last seven years?**** (such a conviction may be relevant if job related, but does not bar you from employment) *

Yes

No

*Please indicate date(s) when you have previously applied to Buckeye Wheel and Tire.

**Please indicate date(s) when you were previously employed by Buckeye Wheel and Tire.

***Please indicate from what company you are laid off and your recall details.

Please do not press to separate text.

****Please explain any felony convictions in the past seven years.

Please do not press to separate text.

Date Available For Work *

MM / DD / YYYY

Referral Source *

Name of Source (if applicable)

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