EMPLOYMENT APPLICATION

Your Personal Information

Select position applying for:(Required)

Your Name(Required)

First M.I. Last

Your Home Address(Required)

Street Address Unit / Suite Number City State Zip Code

Your Phone(Required)

Your Email Address(Required)

Date Available(Required)

Social Security No.(Required)

Desired Salary $

Are you a citizen of the United States(Required)

Yes

If no, are you authorized to work in the U.S?(Required)

Yes

Have you ever worked for this company?(Required)

Yes

If yes, when?(Required)

Have you ever been convicted of a felony?(Required)

Yes

If yes, explain:(Required)

Education

High School:

Address

From

Did you graduate?

Yes

College:

Address

From

Did you graduate?

Yes

Degree Earned

Other Schooling:

Address

From

Did you graduate?

Yes

Degree Earned

References

Please list three professional references:

Full Name:

Relationship

Company

Phone

Address

Full Name:

Relationship

Company

Phone

Address

Full Name:

Relationship

Company

Phone

Address

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for a reference?

Yes

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for a reference?

Yes

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for a reference?

Yes

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for a reference?

Yes

Military Service

Branch

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge(Required)

Yes

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.(Required)

Yes

EMPLOYEE ACKNOWLEDGEMENTS

(1.) Any acceptance of employment will be predicated upon the truthfulness of the written or verbal statements obtained in the pre-employment process. I hereby authorize World Wide Technology Raceway and/or Gateway Kartplex to thoroughly investigate my references, work record, education and other matters related to my suitability for employment. I further authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. I understand that should World Wide Technology Raceway and/or GatewayKartplex find that any statement I have made is not truthful, any job offer extended to me will be withdrawn and if employed, subject to dismissal

(2.) I understand my application is not to be construed or interpreted as a guarantee for employment for a specific time. I further understand that my employment with the organization does not constitute any form of contract, implied or expressed and such employment will be terminable at will either by myself or World Wide Technology Raceway and/or Gateway Kartplex with or without cause or advance notice.

(3) I grant World Wide Technology Raceway and/or Gateway Kartplex approval, after leaving my employment for any reason, to release information which it may deem appropriate regarding my employment with or termination from the organization to anyone who has a reasonable basis for making such inquiry. So long as the information disclosed is not known by the organization to be inaccurate, the organization shall not incur legal liability of any nature in connection with the furnishing of such information. I release all parties and person from any and all liability for any damages that may result from furnishing information related to this application to employer (or prospective employer) or any of its agents,employees or representatives.

(4) I understand that my application for employment will be placed in an active status for a period of six (6) months unless I am hired, or I receive a notification from World WideTechnology Raceway and/or Gateway Kartplex indicating that I am no longer beingconsidered for the role which I applied. I also understand that should I wish to continue being considered for job openings beyond the six (6) month period, I must re-apply by (A) submitting a new application for employment or by (B) submitting a letter requesting renewal of my application and including an update of my qualifications (recent work history, educational achievements, etc.)

AUTHORIZATION FOR RELEASE OF INFORMATION

I hereby authorize Gateway Acquisitions, Inc. DBA World Wide Technology Raceway or Gateway Kartplex and their representatives to conduct a comprehensive review on my background.

I understand that the scope of the background report may include, but is not limited to, the following areas:

Verification of Social Security Number, current and previous residences, employment history including all personnel files, education, character references, credit history and reports, criminal history records from a justice agency in any or all Federal, State County and Municipal Jurisdictions, motor vehicle records to include traffic citations and registration and any other public records.

I authorize the complete release of these records or data pertaining to me which an individual, company, firm corporation or public agency may have. I understand that I must provide my date of birth to adequately complete said screening, and acknowledge that my date of birth will not affect any hiring decisions.

I hereby release Gateway Acquisitions, Inc and their representatives from any and all liability for damages of whatever kind, which may at any time, be personally responsible because of compliance with this authorization and request to release. You may contact me as indicated below.

Date Of Birth(Required)

Social Security Number(Required)

Street Address(Required)

City, State, Zip Code(Required)

Driver’s License #

State of Issue

License Expiration Date

By checking this box and printing your name below I acknowledge that I have read all of the above statements and that I agree to them.(Required)

I agree to the Terms

Enter your full name which shall represent your signature(Required)

Hidden

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Job Application

EMPLOYMENT APPLICATION

Your Personal Information

Education

References

Previous Employment

Military Service

Disclaimer and Signature

EMPLOYEE ACKNOWLEDGEMENTS

AUTHORIZATION FOR RELEASE OF INFORMATION

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