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Employment Application

Name (Last, First Middle):

E-Mail Address:

Phone Number:

Present Address:

City, State, Zip:

Position Applied For:

Referred By:

Names Of Friends or Relatives Employed by This Company:

 

Are you over 18?

Yes No

Are you employed now?

Yes No

Have you ever worked for the Company before?

Yes No

Our retail units are operated 7 days a week and up to 24 hours a day. Are you prepared to be available for work during such time with proper notice?

Yes No

If hired, do you have a reliable means of transportation?

Yes No

Can you, upon employment, submit verification of your legal right to work in this country?

Yes No

Are you bondable?

Yes No

Have you ever been convicted of a crime? (In answering this question, do not include convictions in excess of two (2) years old relating to possession or use of an ounce or less of marijuana, nor any misdemeanor conviction for which probation has been completed. Note: a conviction will not necessarily disqualify you from the postition applied for.)

Yes No
If yes, please explain in the area below.

   

Education:
Name of last school attended:

Previous Work History (list 4):

 1 2

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

 3 4

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

Employer:
Employment Dates: to
Position:
Responsibilities:
Salary:
Reason for Leaving:

 

Are you able to perform all essential functions of the job for which you are applying?

Yes No
If no, explain below.

Are you able to perform all other duties of the job for which you are applying?

Yes No
If no, explain below.

The area below is provided for you to explain anything regarding the above questions.

Enter code:






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