Requested Information
Name:
Date of Birth:
Desired Position:
Phone Number:
Email Address:
Address:
What days of the week can you work?	MondayTuesdayWednesday ThursdayFridaySaturday Sunday
What hours are you available to work?
Is there anything that would keep you from lifting 50lbs or more:	- Choose an Option - Yes No
If yes, please explain:
Have you ever had any relatives or friends work for the company?	- Choose an Option - Yes No
If you answered 'Yes', who? Do you know which position they held?

Employment Questions
Are you over 18?	- Choose an Option - Yes No
Which City Are You Applying For?
Desired Hourly Salary?
Date you can start?
Are you currently Employed?	- Choose an Option - Yes No
Have You Ever applied or worked for Minit-Mart or Minits Before?	- Choose an Option - Yes No
If 'Yes' Which One? Where? and When?
Are You currently laid off or subject to recall?	- Choose an Option - Yes No
Will you work overtime if required?	- Choose an Option - Yes No

Education Information
Highest Education:
School Address:

Employment Record for the Past 5 Years:
Most Recent Employer:
Position Held:
From:
To:
Reason for Leaving:
Supervisors Name:
Phone No:
Employer:
Position Held:
From:
To:
Reason for Leaving:
Supervisors Name:
Phone No:
Employer:
Position Held:
From:
To:
Reason for Leaving:
Supervisors Name:
Phone No:
Employer:
Position Held:
From:
To:
Reason for Leaving:
Supervisors Name:
Phone No:

Employment Information
Do you have any C-Store Experience?	- Choose an Option - Yes No
If 'Yes' How Long?
Do you have any Quick Service Restaurant or Restaurant Experience?	- Choose an Option - Yes No
If 'Yes' How Long?
Do you have your "Safe Serve Certification" for food handling?	- Choose an Option - Yes No
Do you have your "Alcohol Seller Certification" for selling alcohol?	- Choose an Option - Yes No
What was the longest job you've had & why did you leave?
What was the shortest you've had & why did you leave?
We check references. When we check yours, how much notice will your last 3 employers say you gave?
Are you bilingual, and if so what languages do you speak?
If we needed you to come to work on a moments notice could you?	- Choose an Option - Yes No
If no, list reasons why not:
How would you prevent a person from putting gas in their car and driving off without paying for it?
If you saw a customer put something into their pocket, what would you do?
What do you think customers want most from a business and employees like ours?
While in the food prep area we require all our employees to wear hair nets, keep fingernails short, and keep hands clean at all times as well as adhere to all other health and food practices required by law. Will you honor these policies and procedures?	- Choose an Option - Yes No
What do you think this statement means, "we don't get paid for time; we get paid for bringing value to our jobs"?
Would your previous supervisors say you are consistently on time?	- Choose an Option - Yes No
Why or Why Not?
Would your previous supervisors say that your attendance was (choose one):	- Choose an Option - Excellent Good Fair Poor
What does "being organized" mean to you?
Was the previous company you worked for a good company?	- Choose an Option - Yes No
Please Explain.
Was your previous employer fair in regards to pay?	- Choose an Option - Yes No
Please Explain.
Would your previous supervisor say that you were good at following instructions?	- Choose an Option - Yes No
Please Explain.
Would your past supervisors say you get angry (choose one) ?	- Choose an Option - Never Rarely Sometimes Often
What causes you to get upset on the job?
Please choose 3 areas in which you are the weakest: Dilligence, Truthfulness, Loyalty, Orderliness, Punctuality, Initiative, Enthusiasm, Alertness, Availability, Dependability, Honesty.
Please choose 3 areas in which you are the strongest: Dilligence, Truthfulness, Loyalty, Orderliness, Punctuality, Initiative, Enthusiasm, Alertness, Availability, Dependability, Honesty.
What are some of your goals and how will this job help you reach your goals?
Why do you want to work for this company?
Please read this carefully and understand completely: The job we have to offer is: "To do anything and everything the business requires, at any given time". This means you may at any time be asked to: Run a register, cook, wash dishes, mop the floor, take out the trash, clean the restrooms, or anything else that needs to be done. This may be in the c-store, QSR, laundry, outside, or anywhere else the business requires. Is there any type of work you are unwilling or unable to do?	- Choose an Option - Yes No
If 'Yes' Please list what and why you are unable to do it.
We do pre-employment drug testing, random drug testing and probable suspicion drug testing at our discretion in accordance with the law. Do you agree to be drug tested at any time?	- Choose an Option - Yes No
Upload Your Resume: