Name:
First Name
Middle Name
Last Name
Address:
Street Address
City
State
Zip Code
County
Telephone:
Mobile
Fax
Email Address:
Number of months at current residence?
Do you own your home? Or do you rent?
Do you own an automobile? Make Year
Do you have a valid State Drivers License?
Do you have a valid US Social Security Number? (Copies must be provided upon LE's consideration for an independent contractor position)
Do you have income other than current employment? Monthly?
Any physical defects to prevent you from lifting a minimum of 50lbs. or working 8 hours per day with LE?
Any specific experience that would prove valuable as a Field Representative?
Who or what prompted you to apply for this position?
If approved for a territory could you arrange to attend our training school in Ft. Worth, TX?
In the space below please indicate why you would like to be a sales representative for Lubrication Engineers®, Inc. and give at least two reasons why you think you would be successful in this type of sales work.
By clicking this box I certify that all information given by me is true and complete to the best of my knowledge.
Please paste your resume into the box below.
