General Labor Customer Service

TWO MEN AND A TRUCK®

Brian Amey's Employment Application

Date Submitted: 11/20/2017

Job Title: Now Hiring Drivers / Movers - Chattanooga, TN Job Location: Chattanooga

Personal Information

First Name: Brian

Last Name: Amey

Email: advc40@r.postjobfree.com

Current Address

Address: 481 Fairlock Lane

City: Atlanta

State: GA

Postal Code: 30331

Country: US

Contact Information

Home Phone: 404-***-****

Cell Phone: 404-***-****

Preferred method to contact: Email, Call, Text

General Information

1. Do you have a valid driver's license? Yes

2. Do you have any additional driving endorsements? No 3. If yes, please explain: n/a

4. Are you over the age of 21? No

5. Do you have any relevant experience? Select all that apply: Moving, Customer Service, General Labor If Other, please specify: n/a

6. Are you willing to submit to a pre-employment background check and regular drug screens? Yes Convictions and releases on bail will not automatically result in disqualification from employment. TWO MEN AND A TRUCK® reserves the right to conduct a criminal background check. 7. What is your expected starting wage? $10,000 - $20,000 8. What is the highest level of education you completed? High school diploma or GED 9. Have you had any driving violations or accidents in the past 3 years? Yes If yes, please explain: Speeding

10. Which TWO MEN AND A TRUCK® core value applies to you most and why? n/a 11. How did you hear about this job? Current job

12. Do you know anyone who works at TWO MEN AND A TRUCK®? Yes If yes, please state their name, relation to you, and the TWO MEN AND A TRUCK® location where they work: Jeremy (OP. Manager) 4703857917Brian Barbine (OP. Manager) 404-***-**** Employment History

Please provide your employment history. Starting with your most recent job, list the following for each of your last 2 employers.

Current or Most Recent Employer

Company Name: YMCA of Greater Omaha

City and State: Omaha,NE

Title: team member to provide the highest level of service From (MM/YY): 2015-12-01

To (MM/YY): 2016-05-01

Reason for Leaving: n/a

Explanation: n/a

Direct Supervisor: n/a

Company Phone: n/a

OK to contact? n/a

Responsibilities and Duties: n/a

Were you subject to the FMCSRs while employed here? No Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes 2nd Previous Employer

Company Name: n/a

City and State: Boys Town,NE

Title: Student Helper

From (MM/YY): 2015-06-01

To (MM/YY): 2015-08-01

Reason for Leaving: n/a

Explanation: n/a

Direct Supervisor: n/a

Company Phone: n/a

OK to contact? n/a

Responsibilities and Duties: n/a

Were you subject to the FMCSRs while employed here? No Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes Applicant's Statement

I hereby certify the above information to be true and complete.: Yes Today's Date: 2017-11-20

Applicant Signature: Brian Amey Jr.

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