Application for employment

Delco Electric, Inc.

Application for employment


Job Interest/Skills

Employment History

Employer 1

Employer 2

Employer 3


Reference 1

Reference 2


I certify that the answers given by me in this application are correct to the best of my knowledge. I understand that any falsification of this application, whether willingly or accidental, is grounds for disqualification of employment consideration, or dismissal from employment if I am hired. I authorize the company to contact any and all of the references I have listed above to obtain previous employment information or any other pertinent information that they may have. Further, I release the above mentioned references from any and all liability for any damages that may result from information collected by this company. Verification of eligibility to work in the United States must be satisfied for an offer to be made.

Consent to release record(s)

By signing below, I voluntarily give consent to Oklahoma Department of Public Safety or any Motor License Agent to release the following record(s), including personal information within my driver license file. I request the record(s) indicated by my signature below to be released by the Department of Public Safety or any Motor License Agent, their agents and employees, to the following person, company, corporation or legal entity:

Release Record/Information to: Delco Electric, Inc.
MVR Summary: Check

Address of recipient of record: 1 NW 132nd Street, Oklahoma City, OK 73114

NOTICE: As required by the Federal Driver Privacy Protection Act (DPPA), 18 USC Section 2721, the Oklahoma Department of Public Safety/Motor License Agent will not release personal information from your driver record unless you consent by waiving your right to privacy under the DPPA or unless the Department is required by DPPA to release personal information without your consent, such as in connection with matters of safety, theft, emissions, product alterations, recalls, advisories, certain federal laws, or, unless the DPPA authorizes the Department to release it, such as to governmental entities, courts, insurance companies and to others specified.

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