Quick Track Job Application Form

PERSONAL INFORMATION

Application for Employment

Store Number

(Required) Last Name

(Required) First name

M.N.

(Required) Street Address

(Required) City

(Required) State

(Required) Zip Code

(Required) Please select a city you are applying to

(Required) Phone number

(Required) Email Address

(Required) Emergency Contact name and Phone

(Required) Date Of Birth

(Required) Have you ever worked for Quick Track ? NoYes

Have you ever been convicted of a criminal offence ? NoYes

If yes, give details.

EMPLOYMENT INTEREST

(Required) Date available to start

(Required) Type of Employment Full Time (min 30hrs/week)Part Time (less than 30hrs/week)

Please indicate the date and hours you are available to work.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Transport availability YesNo

Desired Salary

(Required) Position Applying for

EDUCATION

Schooling recently attended

School/University Name

City and State

Graduation

Major/Degree

Special Training or Skills

PREVIOUS EMPLOYMENT AND REFERENCES

1. Company Name

Position

Phone No

Address

Wage

Date worked (Beginning To End)

Supervisor

Reason for Leaving

2. Company Name

Position

Phone No

Address

Wage

Date worked (Beginning To End)

Supervisor

Reason for Leaving

3. Company Name

Position

Phone No

Address

Wage

Date worked (Beginning To End)

Supervisor

Reason for Leaving

PREVIOUS ADDRESS

City and State

Conatct # of Owner, if

Date Lived (Beginning-End)

Reason For Moving

REFERENCES

Name

Relationship

Company

Phone

Years

PLEASE, ANSWER THE FOLLOWING QUESTIONS.

1. Do you work well with people ?

2. If hired, how long do you plan on working here ?

3. How do you want to contribute in Quick Track ?

4. What consists of your ideal convenience store ?

5. What do you feel your technology expertise level at ? Beginner, Intermediate, or Advance? Explain.

Upload your Resume

DISCLAIMER AND SIGNATURE

I am at least 18 years of age and older. I give permission to Quick Track to contact my current or previous employer.
I give my full consent to Lama Corporation to perform my background check. If necessary, I certify that all my answers are true and complete to the best of my knowledge.
I understand that false statements in this application may be considered sufficient cause for dismissal.

Signature (Type your Full Name)

Date

OFFICIAL USE ONLY

Office comments.

Please leave this field empty.

Quick Track Job Application Form

Application for Employment

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