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Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, disability, marital or veteran status.

The field descriptions in BOLD text are required.

First Name:  Last Name: 
Address: 
City:  State: 
Zip: 
Phone:  Message Phone: 
Email:
Desired Position:
Preferred Work Location: 

Attach Resume (Optional):
Acceptable formats: .doc, .pdf, .txt

Employment History

Please list chronologically, starting with your present or most recent job.
1) Employer: 
Address: 
From Date:  To Date: 
Phone:  Supervisor: 
Job Title: 
Salary:
Work Performed: 
Reason for Leaving:

2) Employer:
Address:
From Date: To Date:
Phone: Supervisor:
Job Title:
Salary:
Work Performed:
Reason for Leaving:

3) Employer:
Address:
From Date: To Date:
Phone: Supervisor:
Job Title:
Salary:
Work Performed:
Reason for Leaving:

Education

School Name Select Last Year
Completed		 Course of Study Diploma/Degree
High School 
College/University
Graduate/Professional
Business or Trade School

Personal Information

Have you ever worked for PACCAR before? 
If yes, from what dates:
to 		Division / Department
Are you at least 18 years of age? 
(If hired, you will be required to provide verification.)
Are you legally authorized to work in the U.S.?:  
(If hired, you will be required to provide proof of work authorization.)
Have you ever been convicted for other than minor traffic violations within the past seven years? 
If yes, please explain:
(A conviction record will not necessarily bar an applicant from employment.)
What shifts can you work?


Employment desired: 
If temporary, what period of time?
Date available for work: 
Hourly Pay / Salary expected: 
Are you willing to travel? 
Are you willing to relocate? 

Employment References

Please list a minimum of 2 professional references, supervisors if possible.
1) Name:  Company Name: 
Phone Number:  Email:
Relationship:  How Long Known? 

2) Name:  Company Name: 
Phone Number:  Email:
Relationship:  How Long Known? 

3) Name: Company Name:
Phone Number: Email:
Relationship: How Long Known?

General Information

State any additional information you feel may be helpful to us in considering your application.


Voluntary Affirmative Action Program Information

Part of PACCAR’s commitment to an Affirmative Action Program includes giving full consideration for employment to qualified disabled individuals, veterans, ethnic minorities and women.  The following information is being requested of all applicants for employment.  Providing this information is STRICTLY VOLUNTARY.  This self-identification request is made in compliance with the regulation used by the Government, and will assist us with monitoring, recordkeeping and periodic reporting.  This information will be kept separate from your application and will not be used in a discriminatory manner.


Gender:
Race:
Recruitment Source:

Submit Application

Please read carefully before submitting your application
In connection with my application for employment, including any and all attached resumes, I authorize PACCAR Inc to obtain information from all of my past employers, all educational institutions I attended, all agencies that have issued me a professional or vocational license or certification, and all criminal convictions. A past criminal conviction will not necessarily be a bar to employment.  I understand that any false information or material omission in the information I provided to PACCAR Inc will disqualify me from employment consideration or will result in my immediate discharge if hired.  I understand I am free to resign at any time just as the company is free to terminate my employment for any reason at any time.

Any offer of employment is contingent upon the applicant’s successful completion of a urinalysis test for drugs of abuse, a pre-placement physical, and a background check.

SECURITY WARNING: Any information submitted on this form will be transmitted in clear text and not protected in any way.




        

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