ONLINE APPLICATION

       
Date :    
Name :    
SS# :    
Phone :    
Address :    
 

EMPLOYMENT DESIRED
 
Position applying for :
 FULL TIME     PART TIME 
Are you employed now?
 YES     NO 
May we call them?
 YES     NO 
Referred by:
Do you have any friends or relatives working for our company?    YES     NO 
If yes please state name and relationship:    
Ever applied to or worked for this company before?    YES     NO 
When?
Days and hours available for work (please be as specific as possible) :
Weekends?
 YES     NO 
Overtime?
 YES     NO 
What date could you begin working?
Salary Desired :
Alcohol is sold at our locations and by law, employees are required to be 21 years of age to make the sale. Can you meet those requirements?  YES     NO 
Do you have consistent reliable transportation?    YES     NO 
Can you show evidence of your U.S. Citizenship or proof of your legal right to work in this country?    YES     NO 
 

EDUCATION AND EXPERIENCE
 

HIGH SCHOOL

  
   
Name:
Address:
# of years completed:
Did you graduate:
 YES     NO 
Degree, Diploma:
   

COLLEGE OR UNIVERSITY:

  
   
Name:
Address
# of years completed:
Did you graduate:
 YES     NO 
Degree, Diploma:
   

VOCATIONAL BUSINESS

  
   
Name:
Address:
# of years completed:
Did you graduate:
 YES     NO 
Degree, Diploma:
Do you have any experience, training, qualifications or skills that you feel make you especially suited for work at one of our stores?
 

PREVIOUS EMPLOYMENT

LIST BELOW PRESENT AND PAST EMPLOYMENT STARTING WITH YOUR MOST RECENT EMPLOYER
 
NAME OF EMPLOYER:
Address:
Phone:
Position and duties:
Dates of employment: From:
To:
Reason for leaving:
 
NAME OF EMPLOYER:
Address:
Phone:
Position and duties:
Dates of employment: From:
To:
Reason for leaving:
 
NAME OF EMPLOYER:
Address:
Phone:
Position and duties:
Dates of employment: From:
To:
Reason for leaving:
 
NAME OF EMPLOYER:
Address:
Phone:
Position and duties:
Dates of employment: From:
To:
Reason for leaving:
 

REFERENCES

LIST BELOW 3 PERSONS NOT RELATED TO YOU
 
Name: Occupation:
Phone: Number of year's acquainted:
 
Name: Occupation:
Phone: Number of year's acquainted:
 
Name: Occupation:
Phone: Number of year's acquainted:
 
Read carefully and initial each paragraph and sign below:
     I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.
 
     IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO SULLIVAN PETROLEUM COMPANY RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME.


Print Name: Print Date:
 
Signature: Signature Date:


Enter the Security Code :