*Required Fields

APPLICATION FOR EMPLOYMENT

WE ARE AN EQUAL OPPORTUNITY EMPLOYER
APPLICANT'S STATEMENT

DO NOT SIGN OR SUBMIT AN APPLICATION UNTIL
YOU HAVE READ THE ABOVE STATEMENT
Last Name First Name Middle Name
* *
Address City State Zip
* * * *
Telephone Number(s) E-mail address
* *
Personal Information
Date You Are Available For Work :

Are you available to work      Full Time  Part Time (Please indicate 1 2 3 shift)
Can you travel if the job requires it?  Yes  No
Position Applied For  *    
Date of Application  *
Location Applied For  
How Did You Learn About Us?
        Newspaper     Friend/Relative     Monster.com    Yahoo.com    CareerBuilder.com    
        Radio     Employment Agency     Other :
Best Time To Contact You At Home 
Are you 18 years of age or older?   Yes    No
Have you ever worked for this company before?   Yes    No
If yes, please give dates and position:

Do you have any friends or relatives working here?   Yes    No
If yes, Name:

Do you have a reliable means of transportation to travel to and from work which will allow you to consisitently arrive at work on time?
Yes No
If a driver's license is required for the position for which you are applying, do you have a valid driver's license?
Yes No
Have you been cited for a traffic violation of any kind within the last FIVE years? Yes No
If yes, please give date and details of each:

Have you ever pled guilty or "no contest" to a crime or been convicted of a crime? Yes No
If yes, please give date and details of each:

Education
School
Name and Address of School
Course of Study
Years Complete
Diploma/Degree
High School
Military
Other
(Specialized Training)
Personal/Professional References
Please list persons who know you well not previous employers or relatives.
Name
Phone Number
Best Time To Call
Occupation
Work Experience
Start with your present job. Include any job related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status.
Dates Employed
Work Performed
Employer From To
Address, City, State
Hourly Rate/Pay
Telephone Number Starting Ending
Starting/Present Job Title
Supervisor
Reason For Leaving
May we contact this employer?Yes No
Dates Employed
Work Performed
Employer From To
Address, City, State
Hourly Rate/Pay
Telephone Number Starting Ending
Starting/Present Job Title
Supervisor
Reason For Leaving
May we contact this employer?Yes No
Dates Employed
Work Performed
Employer From To
Address, City, State
Hourly Rate/Pay
Telephone Number Starting Ending
Starting/Present Job Title
Supervisor
Reason For Leaving
May we contact this employer?Yes No
Dates Employed
Work Performed
Employer From To
Address, City, State
Hourly Rate/Pay
Telephone Number Starting Ending
Starting/Present Job Title
Supervisor
Reason For Leaving
May we contact this employer?Yes No
Dates Employed
Work Performed
Employer From To
Address, City, State
Hourly Rate/Pay
Telephone Number Starting Ending
Starting/Present Job Title
Supervisor
Reason For Leaving
May we contact this employer?Yes No
Do you have any unemployed periods in your employment history?Yes No
If yes, please give dates and explain:

Have you ever been terminated or asked to resign from any job?Yes No
If yes, please explain the circumstances:

What are your salary requirements? required From $ to
Additional Information
Please indicate any actual experience you have in any of the following positions:
Office
Office Manager
Bookkeeper
Accounts Receivable
Accounts Payable
Payroll Clerk
Tag/Title Clerk
Warranty Clerk
Data Entry
Cashier
Sales/Leasing
Sales Manager
Sales Person(Truck)
F & I Manager
Leasing Manager
Fleet Manager
Service and Repair
Service Manager
Service Writer/Advisor
Dispatcher
Shop Foreman
Mechanic/Technician
Electrician
Helper
Painter
Body Repair
Parts
Parts Manager
Parts Counter
Parts Stocker
Parts Driver
Shipping and Receiving
Specialized Skills
(Skills/Equipment operated)
PC/Windows
Keyboarding
WPM
Spreadsheet
Word Processing
10 Key
Strokes/Hour
State any additional information you feel may be helpful to us in considering your application.


THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF THIRTY (30) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.

I CERTIFY THAT ALL THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE AND ACCURATE


Service Technician Evaluation

The position you selected also required the following form to be filled out.

Please put a check in every box for which you have received an ASE certification.
 

ASE Medium Heavy Truck Certifications

      T1 Gas Engines
      T2 Diesel Engines
      T3 Drive Train
      T4 Brakes
      T5 Suspension and Steering
      T6 Electrical Systems
      T7 Heater and Air Conditioning
      T8 Preventive Maintenance Inspection
      L2 Electronic Engine Systems


Please put a check in each box for procedures you are competent to perform on class 6,7,& 8 trucks.

Front Axle and Steering

      Replace Front Axle Beam 
      Replace King Pins 
      Replace Tie Rod Assembly 
      Replace Drag Link Assembly 
      Adjust Steering Sector 
      Replace Steering Gear 
      Replace Power Steering Pump 
      Use Power Steering System Analyzer 
      Replace Spring Shackles and Pins 
      Replace Wheel Seals 
      Replace U-Joints 
      Align Drive Shaft 
      Time Drive Shaft 
      Replace Shocks 
      Replace Pinion and Thru-shaft Seals 
      Overhaul Differential 
      Replace Air Ride Valve and Adjust 
      Replace Air Ride Springs 
      Replace Air Bag Assemblies 
      Rebuild 5th Wheel 
      Replace Frame Rail
 

Electrical and Electronics

      Replace Alternator 
      Adjust Voltage Regulator 
      Replace Batteries 
      Replace Battery Cables 
      Replace Starter 
      Replace Starter Solenoid 
      Replace Ignition Relay 
      Understand Wiring Diagrams 
      Can use a Multi-Meter 
      Troubleshoot Starting System 
      Troubleshoot Charging System 
      Troubleshoot Basic Electrical Systems 
      Understand Electronics


Welding

      Can Arc Weld 
      Can Wire Weld Steel 
      Can Wire Weld Aluminum 
      Can Tig Weld 
      Can Braze Weld 
      Can Operate Cutting Torch 

 Maintenance

      Replace Oil Filters 
      Replace Water and Fuel Filters 
      Change Oil 
      Check Coolant with Refractometer 
      Grease Chassis 
      Replace Air Cleaner Assembly 
      Perform PM Maintenance 
      Perform Pre-Delivery Inspection 
      Perform DOT Inspection


Diesel Engine
Have you Overhauled . . .

   .. a Series 60 Detroit Engine
   .. Heavy Duty Caterpillar Engines
   .. Medium Duty Caterpillar Engines
   .. Heavy Duty Cummins Engines
   .. Medium Duty Cummins Engines 
   Have Caterpillar Engine Certifications 
   Have Detroit Engine Certifications 
   Have Cummins Engine Certifications 
   Can use Caterpillar Diagnostic Equipment 
   Can use Detroit Diagnostic Equipment 
   Can use Cummins Diagnostic Equipment 
   Replace Rod and Main Bearings 
   Replace Turbo Charger 
   Replace Water Pump 
   Troubleshoot Cooling System 
   Install Engine Brake 
   Run Overhead 
   Replace Exhaust System 
   Repair Minor Oil Leaks 
   Replace Oil Cooler
 


Required Certifications

      Refrigerant Handling Certification 
      CDL Class A or B 
      DOT Inspection Certification


Please put a check in each box for procedures you are competent to perform on class 6,7,& 8 trucks.

Air Systems and Brakes

      Replace Linings on Inboard Hubs 
      Replace Linings on Outboard Hubs 
      Adjust Manual Slack Adjusters 
      Adjust Automatic Slack Adjusters 
      Replace Slack Adjuster 
      Replace Park Brake Assembly 
      Troubleshoot Air Brake Systems
      Replace Air Compressor 
      Replace Air Governor 
      Replace Tractor Protection Valve 
      Replace Foot Valve 
      Replace Trailer Hand Valve 
      Replace Park Brake Valve 
      Rebuild Air Dryer 
      Troubleshoot ABS 
      Repair ABS 
      Troubleshoot Hydraulic Brakes 
      Repair Hydraulic Brake Systems


Air Conditioning and Heating

      Replace Compressor 
      Replace Clutch 
      Replace Receiver Drier 
      Replace Expansion Valve 
      Evacuate System 
      Recover System 
      Recharge System 
      Troubleshoot the A/C System 
      Troubleshoot ACPU 
      Replace Heater Core 
      Replace Heater Valve 
      Replace Blower Motor 
      Replace Resistor Block 
      Replace A/C Belt 
      Replace Heater Hoses 
      Replace A/C Lines 
      Overhaul Fan Clutch


Transmission and Clutch

      Replace Transmission Assembly 
      Replace Yoke Seal 
      Overhaul Front Box 
      Overhaul Back Box 
      Understand 10 Speed Operation 
      Understand 13 Speed Operation 
      Overhaul Automatic Transmission 
      Overhaul Auxiliary Boxes 
      Install PTO Assemblies 
      Replace Single Disc Clutch 
      Replace Dual Disc Clutch 
      Replace Pilot Bearing 
      Replace Clutch Brake 
      Replace Flywheel and Ring Gear 
      Replace Flywheel Housing 
      Replace Transmission Input Shaft 
      Adjust Clutch 
      Troubleshoot and Repair Eaton Gen 1 and Gen 2 SmartShift Transmission 
      Troubleshoot and Repair Meritor SureShift Transmission
      Troubleshoot Eaton Top 2 Transmission
      Troubleshoot Rockwell ESS Transmission

Paint And Body

      Can use Fiberglass Resin and Mat 
      Can use Fiberglass Filler 
      Can Spray Imron Paint 
      Can Spray Clear Coat Systems 
      Can Replace Windshields

Gas Engine

      Have You Overhauled Dodge Engines  
      Have You overhauled Chevrolet Engine 
      Have You Overhauled Ford Engines 
      Can You Use Diagnostic Equipment 
      Can You Perform Gas Engine Tune-Up 
      Can You Adjust Mechanical Valves 
      Can You Adjust Hydraulic Valves 
      Can You Replace a Distributor

If you answered "Yes" to any of the Engine Overhaul questions please explain the extent of your experience.


Are there any items not previously discussed that you have experience in that would be useful in this position? 

 
Will you work overtime?   Yes    No
 
Will you work the night/second shift?   Yes    No
 
Do you have adequate tools to start work?   Yes    No
 
Do you have impact/pneumatic wrenches?   Yes    No

If yes on impact/pneumatic wrenches: Maximum Size? 

 

What size do your sockets go up to? 

 
What is your maximum size of torque wrench? 
inches. 
foot lbs. 
 
If you had to put a value on your tools, what would it be? 

 
When can you begin employment with Omaha Truck Center, Inc.? 

 
Are you willing to study at home to assist your training?   Yes    No
 
Are you willing to travel to seminars?   Yes    No
 
Do you know anyone else looking for work in this field? Please list name and phone number. 

Omaha Truck Center, Inc.
10550 I Street
Attn: Recruiting
PO Box 27379
Omaha, NE 68127
       402-951-3380        Toll Free 800-777-2440