MECHANIC

Name:Date

Email address:

Feel free to reformat this form on your own computer.

EXPERIENCE AND KNOWLEDGE: (briefly describe your experience in the following areas and indicate number of years of experience)

Trucks

Do you have a Commercial Driver’s License? yes no

If yes, approximately how many years?

Have you done maintenance/repair of pickup trucks and cars? yes no

If yes, approximately how many years?

Have you done maintenance/repair of larger trucks, such as flatbeds? yes no

If yes, approximately how many years?

Have you done maintenance/repair of trucks with hydraulic systems? yes no

If yes, approximately how many years?

Have you driven dual rear axle truck? yes no

If yes, approximately how many years?

Have you driven truck/trailer combination? yes no

If yes, approximately how many years?

If yes, approximately how many times did you back up with trailer?

Have you driven larger trucks with aerial manlift? yes no

If yes, approximately how many hours?

Equipment

Have you done maintenance/repair of forklifts: yes no

If yes, approximately how many years?

Have you done maintenance/repair of hydraulic derricks/booms: yes no

If yes, approximately how many hours?

Other Equipment – Specify type and maintenance/repair experience:

EXPERIENCE AND KNOWLEDGE (continued):

Operated Tools

Small hand tools yes no

Electric Drill yes no

Air wrench yes no

Chain saw yes no

Hydraulic tools yes no

Other (specify below)

Describe your experience and knowledge in the following areas:

Preventive maintenance practices for vehicles and equipment

Current automotive electronic systems (describe)

Hydraulic systems

Diesel engines (describe)

Brake systems

Cooling Systems

Pneumatic systems

Fuel systems

Welding applications

Procedures for ordering parts and maintaining appropriate stock levels

Safe work practices

Other related experience

EDUCATION AND TRAINING:

High school diploma or equivalent? yes no

Name of High School

College, University, or TechnicalSchool attended

Years Attended

Degree, certificate, classes taken

Industrial First Aid card? yes no

Washington State Flagging and Traffic Control card? yes no

Additional education/special training and related courses:

Specify how you heard about this job opening:

Ad:Name of Newspaper

Website:URL

Referred by:Name

Other:

SignatureDate

Mechanic SQ 10/2017