Name First* Last*
Contact Information Street* City* Zip* Length at this address (months or years): Phone* Alternate Phone Email*
Part TimeFull Time
Location Desired -Select a Store-Agoura HillsAlhambraAlisa ViejoAnaheim (E Lincoln Ave)Anaheim (W Lincoln Ave)Anaheim (W Ball Rd)Apple Valley (Bear Valley Rd)Apple Valley (US Hwy 18)ArcadiaAzusaBellflowerBurbankCamarilloCanoga ParkCanyon Country (Soledad Canyon Rd)Canyon Country (Via Princessa)ChinoChino HillsColtonCoronaCorona (W 6th St)Corona (E Ontario Ave)Costa Mesa (E 17th St)Costa Mesa (Newport Blvd)CovinaCulver CityCypressDiamond BarDowney (Firestone Blvd)Downey (Lakewood Blvd)FilmoreFontanaGarden GroveGardenaGlendaleHawthorneHemetHesperia (Main St)Hesperia (Bear Valley Rd)HighlandHuntington Beach (Adams Ave)Huntington Beach (Warner Ave)Irvine (Main St)Irvine (Irvine Center Dr)La Canada FlintridgeLa HabraLa PuenteLake ElsinoreLakedoowLancasterLomitaLong Beach (Pacific Coast Hwy)Long Beach (Long Beach Blvd)Long Beach (E 7th St)Los AlamitosLos Angeles (W Sunset Blvd)Los Angeles (W Pico Blvd)Los Angeles (N La Brea Ave)Los Angeles (W Manchester Ave)Los Angeles (Overland Ave)Los Angeles (Santa Monica Blvd)LynwoodManhattan BeachMission ViejoMontebelloMoorparkMoreno ValleyNorcoNorthridge (Reseda Blvd)Northridge (Devonshire St)Ontario (Mills Cir)Ontario (S Vineyard Ave)OrangeOxnard (W 5th St)Oxnard (W Esplanade Dr)Palmdale (W Rancho Vista Blvd)Palmdale (25th St E)Pasadena (E Walnut St)Pasadena (E Colorado Blvd)Perris (Case Rd)Perris (E Ramona Expy)PomonaQuartz HillRancho CucamongaRancho Santa MargaritaRedandsResedaRiversideRowland HeightsSan Bernadino (University Pkwy)San FernandoSan JacintoSanta AnaSanta MonicaSherman OaksSimi Valley (1515 E Los Angeles)Simi Valley (4426 E Los Angeles)Stevenson RanchSun ValleySylmarTarzanaTemeculaThousand Oaks (2905 E Thousand Oaks)Thousand Oaks (1695 E Thousand Oaks)Torrance (5340 W 190th St)Torrance (3209 W 190th St)Torrance (Sepulveda Blvd)TustinTwentynine PalmsUpland (E Foothill Blvd)Upland (W Foothill Blvd)Van NuysVenturaVictorvilleWestchesterWestminsterWhittier (Lambert Rd)Whittier (Colima Rd)WildomarYorba LindaYucca Valley
Have you ever worked for Jiffy Lube before? Yes If yes, please tell us where you worked, when (dates) and your position:
Do you have adequate transportation to and from work? Yes If your job requires moving vehicles, do you have a valid CA Drivers License? Yes Are you a veteran or active member of the U.S. Armed Forces? Yes
Please list your previous experience and/or employers in order below with present or last experience and/or employer listed first. Please include all periods of time including military service and any period of unemployment.
Last Employer: Address: City: Zip: Phone: Position Held: Name of Supervisor: Employment Dates:
Previous Employer: Address: City: Zip: Phone: Position Held: Name of Supervisor: Employment Dates:
Additional Training (Automotive, Retail, Management): Description: Diploma/Degree: Course of Study:
I UNDERSTAND THAT TO BE CONSIDERED FOR EMPLOYMENT, I WILL NEED TO COMPLETE AN EMPLOYMENT APPLICATION FOR JIFFY LUBE. I ALSO UNDERSTAND THAT JIFFY LUBE IS A DRUG-FREE WORKPLACE AND AS A CONDITION OF ANY EMPLOYMENT OFFER, I WILL NEED TO PASS A PRE-EMPLOYMENT DRUG SCREEN AND BACKGROUND CHECK. I CERTIFY THAT ALL OF THE INFORMATION I HAVE PROVIDED IS TRUE.