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    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) 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
    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. Would you consider greeting customer as an important things to do in the convenience store business ?
    5. A Co-worker is rude to your customers, what would you do ?
    6. You are working alone and your shift is due to be over, but your replacement does not show up ? What would you do ?
    7. You discover one of your co-workers giving free merchandise to his friend, What would you do ?
    8. What consists of your ideal convenience store ?
    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 Himalayan Aroma 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, send this form to payroll@quicktrackinc.com or FAX to 817-545-9212


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