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Employment Application
Employment Application Form
Step
1
of
3
- Your Information
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Please note: this is a physically demanding job and you will be on your feet the duration of your shift
Position Applying For
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Are you able to perform the essential functions of the position with or without accommodations?
Yes
No
Are you 16 years old or older?
Yes
No
I am able to
Work the following shifts? (check all that apply)
Any
Day
Night
Split
Work overtime?
Yes
No
Provide a valid Texas Driver's License?
Yes
No
I am legally eligible for employment in the U.S.?
Yes
No
I am seeking a permanent position?
Yes
No
List any time/day limits here (e.g. school hours you are unavailable, Sunday mornings, etc.):
I will be able to report to work ______ days after being notified that I am hired.
Position Application
List most recent employment first. Include summer/temp jobs. List all experience or employers related to this job, in the summary following this section.
What Position are You Applying For
(Required)
Please Select
Customer Service Attendant
Shift Leader
Assistant Site Manager
Site Manager
Sales Associate
Are you interested in a Full or Part-time Position?
(Required)
Full-time
Part-time
If needed, can you work a morning shift beginning at 6:30 am?
(Required)
Yes
No
If needed, can you work an evening shift ending at 8:30 pm?
(Required)
Yes
No
Are you a US citizen?
(Required)
Yes
No
Are you authorized to work in the US?
(Required)
Yes
No
How did you hear about us?
Previous work experience.
Previous Employer #1
Company
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Job Title
Supervisor
Starting Pay
Ending Pay
Responsibilities
From / To
Reason for Leaving
May we contact your previous supervisor for reference?
Yes
No
Previous Employer #2
Company
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Job Title
Supervisor
Starting Pay
Ending Pay
Responsibilities
From / To
Reason for Leaving
May we contact your previous supervisor for reference?
Yes
No
DISCLAIMER
(Required)
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. By submitting this form you are accepting this as your e-signature for this employment application.
Accept
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