Employment Application

Employment Application

Employment Application

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or the presence of a non-job related medical condition or handicap.

Employee Information

Name

Current Address *
Current Address
City
State/Province
Zip/Postal

Addresses for the past three years:

Address *
Address
City
State/Province
Zip/Postal
Address
Address
City
State/Province
Zip/Postal
Are you able to perform the essential functions of the position with or without accommodations? *
If necessary for the job, I am able to work overtime? *
If necessary for the job are you older than: *
Provide a valid drivers license? *
If yes, fill out the following:
Endorsement(s):
Work the following shifts: (check all that apply) *
Are you currently employed? *
May we contact your current employer? *
Have you worked at TK Gas before? *

Employment History

List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.

Previous Employer

Employer Address
Employer Address
City
State/Province
Zip/Postal
Safety Sensitive Function?
Subject to part 40 Drug & Alcohol?

Previous Employer

Previous Employer

Previous Employer

Previous Employer

Education

High School

College / University

Business Technical

Additional

Military

Are you a veteran?

Skills & Qualifications

References (other than family)

Reference

Address *
Address
City
State/Province
Zip/Postal

Reference

Address *
Address
City
State/Province
Zip/Postal

Emergency Contact


In case of accident or illness, please contact:

Address *
Address
City
State/Province
Zip/Postal

CDL Driver Information Only


All driver applicants must provide the following information on all employers during the preceding 10 years. Applicants MUST give complete address, phone number, and contact persona for all previous employers.

Previous Employer

Employer Address
Employer Address
City
State/Province
Zip/Postal
Safety Sensitive Function?
Subject to part 40 Drug & Alcohol?

Previous Employer

Previous Employer

Previous Employer

Accident Record For Past 3 Years

Last Accident

Next Previous:

Next Previous:

Next Previous:

Traffic Convictions and Forfeitures for the Past 3 Years

Traffic Conviction

Traffic Conviction

Traffic Conviction

Traffic Conviction

Experience and Qualifications -- Driver:

Driver License Information

A) Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
B) Have you ever had any license, permit or privilege suspended or revoked?

If the answer to either A or B is yes, attach statement giving details

File Upload
Maximum upload size: 134.22MB

Driving Experience

Straight Truck

Tractor & Semi Trailer

Tractor - Two Trailers

Other

Information to the Applicant

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its terms. I understand and agree to the information shown above.

Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment.