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603-841-5291

Application for Employment

We are an Equal Opportunity Employer and are committed to excellence through diversity.

The application must be fully completed to be considered. 

*Indicates information required in order to submit application. Sections with multiple input options (Education, References, & Employers) require at least one of each fully completed.

Any questions, issues, or concerns can be directed to Paul by e-mailing Paul@RogersAutoBody.com or calling 603-841-5291.

    Personal Information




    State:*

    Zip Code:*

    Are You a U.S. Citizen?*

    Have You Ever Been Convicted of a Felony?*

    If Selected For Employment Are You Willing To Submit to a Pre-Employment Drug Screening Test?*

    Position

    Position You Are Applying For:*

    Available Start Date:*

    Employment Type Desired:*

    Education

    School One*

    School Name:
    Location:
    Years Attended:
    Degree Received:
    Major:

    School Two

    School Name:
    Location:
    Years Attended:
    Degree Received:
    Major:

    School Three

    School Name:
    Location:
    Years Attended:
    Degree Received:
    Major:

    School Four

    School Name:
    Location:
    Years Attended:
    Degree Received:
    Major:

    References

    Reference One*

    Name:
    Job Title:
    Company:
    Phone:

    Reference Two

    Name:
    Job Title:
    Company:
    Phone:

    Reference Three

    Name:
    Job Title:
    Company:
    Phone:

    Employment History

    Employer (1)*

    Employer:
    Job Title:
    Dates Employed:
    Work Phone Number:
    Starting Pay Rate:
    Ending Pay Rate:
    Employer Address:
    Employer City:
    Employer State:
    Employer Zip:

    Employer (2)

    Employer:
    Job Title:
    Dates Employed:
    Work Phone Number:
    Starting Pay Rate:
    Ending Pay Rate:
    Employer Address:
    Employer City:
    Employer State:
    Employer Zip:

    Employer (3)

    Employer:
    Job Title:
    Dates Employed:
    Work Phone Number:
    Starting Pay Rate:
    Ending Pay Rate:
    Employer Address:
    Employer City:
    Employer State:
    Employer Zip:

    Employer (4)

    Employer:
    Job Title:
    Dates Employed:
    Work Phone Number:
    Starting Pay Rate:
    Ending Pay Rate:
    Employer Address:
    Employer City:
    Employer State:
    Employer Zip:

    Employer (5)

    Employer:
    Job Title:
    Dates Employed:
    Work Phone Number:
    Starting Pay Rate:
    Ending Pay Rate:
    Employer Address:
    Employer City:
    Employer State:
    Employer Zip:

    Resume (Optional. Max Size 3mb. File Types: .txt/.pdf/.doc)

    Signature Disclaimer

    Signature

    By entering your First and Last Name, you agree that this submission acts as your official digital signature.

    Note: Please do not exit or refresh this page after clicking the “Submit” button until you see a Confirmation Message indicating your form has been submitted successfully. Check your email for a confirmation message that your application has been received. If you do not receive a confirmation email within 24 hours, please call us at 603-841-5291 to verify receipt. Thank you!