form - Faststop Petroleum

EMPLOYMENT APPLICATION

Contact Information

* Name:

*Address 1:

Address 2:

*City:

*State:

*Zip:

* Phone:

Cell Phone Carrier:

Email:

Attachments

Resume:

Supported formats: Word, PDF, RTF, Text, and HTML. - or Upload from:

Cover Letter:

You can type in a Cover Letter or Copy/Paste from an existing document.

BASIC INFORMATION

*What position or positions are you applying for?:

*What is the date of this application?:

*How did you learn about us?:

Advertisement
Friend
Walkin
Employment Agency

Relative

If none of the above apply, please describe below how you learned about us:

*Primary phone number:

Secondary phone number:

Other phone number:

*Social Security Number:

Shirt Size:

Pant Size:

Shoe Size:

Do you have transportation?:

Yes No Other

How far do you live from store?:

Have you ever been counseled for cash handling situations?:

Yes No

ELIGIBILITY INFORMATION

*Are you 18 years of age or older?:

Yes No

*If you are under 18 years of age, can you provide required proof of eligibility to work?:

Yes No

*Are you currently employed?:

Yes No

May we contact your present employer?:

Yes No

*Have you ever filed an application with us before?:

Yes No

If yes please give date of previous application:

If hired, can you show proof of identity and legal authorization to work in the United States?:

Yes No

(Proof of citizenship or immigration status will be required upon employment.)

On what date will you be available for work:

*Are you available to work?:

Full Time Part Time Temporary

Are you currently on 'lay-off' status and subject to recall?:

Yes No

If presently employed, why do you desire to change your position?:

Have you been convicted of a criminal offense within the last 7 years?:

Yes No

(Conviction will not necessarily disqualify an applicant from employment.)

Physical

Do you know how to send/receive Email?:

Yes No

Do you know how to use Calculator?:

Yes No

Which Computer Operating System you know how to use?:

Windows XP Windows 7 Windows 8
Windows 10 Mac

Which computer program you know how to use?::

Word Excel Power Point
Outlook

AVAILABILITY

EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed

Employer Name & Address

Employer Phone

Job Title

Supervisor Name & Title

May we Contact?

Yes
No

Responsibilities

Reason for Leaving

Salary/Hourly Rate

EMPLOYER 2

Dates Employed

Employer Name & Address

Employer Phone

Job Title

Supervisor Name & Title

May we Contact?

Yes
No

Responsibilities

Reason for Leaving

Salary/Hourly Rate

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

If you have completed any special courses, seminars and/or training that would help you to perform the position for which you are applying, please describe:

REFERENCES

Please provide three personal references (not relatives).

Name

Relationship

Phone Number

PROFESSIONAL REFERENCES

Name

Address

Phone #

Rate Your Self Section

Have you ever worked on a cash register?:

Yes Unsure No

Have you ever worked an electronic “Point-of-Sale” (POS) cash register?:

Yes Unsure No

Have you ever held or been elected to a leadership position?:

Yes Unsure No

Do you know anyone that works at this convenience store?:

Yes Unsure No

Do you think hard work can also be fun?:

Yes Unsure No

Do you consider yourself a hard worker?:

Yes Unsure No

Would you describe yourself as a happy, enthusiastic person?:

Yes Unsure No

Can you be smiling and happy through your full shift?:

Yes Unsure No

If you had a choice , would you rather

Work in front with customers? Or

Work in back cooking and preparing the food?

APPLICANT'S STATEMENT

I certify that answers given herein are true and complete to the best of my knowledge. I understand that falsification, omission or misstatement of information may result in refusal to hire or, if hired, termination of employment. I hereby give permission to FASTSTOP and any third party it so chooses to utilize, to conduct a personal check on my background, including but not limited to, work history, business and personal record and/or references, credit history, or criminal investigation, and hold harmless the above referenced. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications am being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with the organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge employee at my time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. I understand, also, that I am required to abide by all rules and regulations of the employer.

* Type full name:

*Date:

CONSUMER REPORTS

(Including Motor Vehicle Reports and Credit Reports)

The Fair Credit Reporting Act (FCRA) provides individuals with certain rights regarding consumer reports and places certain obligations on employers using consumer reports for employment-related purposes. Consistent with the FCRA's requirements, this notice is provided to you in order to inform you that FASTSTOP may, for employment-related purposes (e.g., evaluating you for initial employment, promotions, transfers, assigned duties, retention as an employee, etc.) obtain from a consumer reporting agency one or more consumer reports containing financial information, criminal record information, driving record information and/or relevant information about you. FASTSTOP will not obtain a consumer report without your signature below authorizing us to obtain one or more consumer reports.

AUTHORIZATION TO OBTAIN CONSUMER REPORTS

I hereby acknowledge that I have read and understand the contents of the above notice and, by signing below, specifically authorize FASTSTOP to obtain one or more consumer reports on me for employment-related purposes as indicated above.

* Type full name:

*Date:

The Secretary of Health & Human Services has determined that certain diseases, including Hepatitis A, typhoid fever(Salmonella typhi), shigellosis(Shigella spp.), and E coli(Escherichia coli 0157:H7) may prevent you from serving food or handling food equipment in a sanitary or healthy fashion. An essential function of this job involves handling & serving food, food service equipment and utensils in a sanitary and healthy fashion.

Are you able to perform the essential functions of this job with or without a reasonable accommodation?: :

Yes No

If no, please explain?:

DRIVING RECORD

* Are you an employee?:

Yes No

* Are you a prospective employee?:

Yes No

*Please enter your date of birth:

Please enter the state that issued your driver's license:

Please enter your driver's license number:

* Have you ever been denied a driver's license or had one suspended or revoked?:

Yes No

*Have you had any violations in the past 3 years?:

Yes No

*Have you had any auto accidents in the past 3 years?:

Yes No

*IF THE ANSWER TO ANY QUESTIONS WAS YES, please explain (give dates of violations and/or accidents):

DRIVER- I affirm that the statements made above are stated truthfully and without reservation.

*Type full name:

*Date:

PREVIOUS ADDRESSES

Please list the street address (or PO Box), city, state, zip code, county and length of time resided at all previous addresses for 7 years.

*Current Address:

Former Address:

Other previous addresses:

NOTE: WE NEED ALL ADDRESSES FOR THE PAST SEVEN YEARS.

PERSONAL HISTORY

Maiden Name/Former Married Name:

Date of Change

* Social Security Number:

* Daytime Telephone Number:

* Driver License or State ID Number:

State of issuance:

* Date of birth:

* Have you ever been convicted of a crime or convicted in a military court?:

Yes No

Have you ever been sanctioned or had your licenses suspended or revoked?:

Yes No

Are you currently under any investigation or pending charge?:

Yes No

This information will enable us to properly identify you in the event we find adverse information during the course of our background search. The Credit Information Center is a division of the Credit Bureau of Nashville, Inc.

APPLY FOR FUEL TRANSPORT

Application For Employment

APPLICATION FOR EMPLOYMENT

EMPLOYER 1

EMPLOYER 2

If you had a choice , would you rather

(Including Motor Vehicle Reports and Credit Reports)

AUTHORIZATION TO OBTAIN CONSUMER REPORTS