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EMPLOYMENT APPLICATION
First Name Middle Name Last Name
Social Security Number Date
________________________________________________________________________________________________________
Present Street Address
City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NB NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip
PreviousStreet Address
_________________________________________________________________________________________________________
Home Phone Business Phone
Federal law prohibits discrimination in employment because of age. Are you 18 or older? Yes No
Can you, at the time of employment, submit verification of legal right to work in U.S? Yes No
If you are applying for a Driver's position, are you DOT qualified? Yes No
What job are you applying for?
Beginning with the last or present employer, list all employers for whom you have worked, either full-time or part-time - including military service. Account for all periods of employment and time you were attending school full time.
EMPLOYMENT HISTORY
1.) Employer Name
Employment Date - From (mo/yr)
- To (mo.yr)
Employer Address
Employer Phone Number Supervisor's Name & Title
Base Salary or Hourly Rate Hours Worked per Week
Reason for Leaving
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2.) Employer Name
3.) Employer Name
_____________________________________________________________________________________________________________
EDUCATION
High School Name
School Address
Major Did you graduate? Yes No
Grade Average
Vocational School Name
____________________________________________________________________________________________________________
College/University Name
List other skills, trades, training and/or work experience that were not mentions above.
Experience, Skill Training or Profession:
Company, School or Military:
No. of Years
______________________________________________________________________________________________________________
General Information
How were you referred to this company?
Have you ever been employed by this company or subsidiary?
If yes, list name of company and location.
Dates of employment:
If driving is essential to this job, do you have a valid driver's license? Yes No
If yes, please list license no. State:
Have you ever been convicted of a felony? Yes No
If yes, state particulars:
Additional comments you feel are important to the consideration of your application:
I am applying for a position with TRAIL'S TRAVEL CENTER. If I am employed, I agree that my employment with the Company is at the will of the Company, which means that the Company has the right to discharge me for any reason or no reason with or without notice. I also understand that I may be terminated or laid off at the discretion of the Company. I expressly agree and understand that this is the entire agreement between the Company and myself o the subject of discharge, termination and/or lay off, and it may be changed only by an agreement in writing, signed by the President of the Company. I agree to conform to the Company rules, and I also agree that I shall be subject to other conditions which the Company may adopt at its sole discretion.
I affirm that the information on this application is true and complete, and that intentional deception herein will result in disqualification or dismissal if employed.
In connection with my application for employment, I understand that a thorough credit and background check may be made. I hereby authorize any educational institution past or present employer, law enforcement agency or any person who had knowledge of my education, work experience and/or criminal conviction record to release this information to TRAIL'S TRAVEL CENTER, or it's agents. I hereby release all persons from liability as a result of providing true, accurate information.
I have read and/or had explained to me the job description and corresponding physical and mental requirements of the position for which I am applying. I can perform all essential job duties Yes No
If No, I can perform all essential job duties except:
I am requesting the following accommodation:
Date:
