QuikTrip

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QuikTrip Employment Application
*For what position are you applying? Full-time Assistant Manager
Part-time Clerk
Non-store Position
*For which market area are you applying?

Personal Information
*Full legal name
*Street address
*City
*State
*Zip
*Telephone number  ex(999)999-9999  
Have you ever worked at QuikTrip before? Yes
No
If so, when?  ex (01/01/00) to
Position
Division
Have you ever applied at QuikTrip before? Yes
No
If so, when?  (ex 01/01/00)
Can present employer be contacted? Yes
No
Do you have reliable transportation? Yes
No
Were you referred by a QuikTrip employee? Yes
No
If so, whom?
*Desired starting pay ($)
Per hour
Per week
*How many hours per week do you want to work?
During what times are you available to work?
*Are you willing to work:
(Check all that apply.)		 Nights
Overtime
Weekends
Holidays
*When could you begin work?  (ex 01/01/00)   
Are you at least 16 years old? Yes
No
Are you at least 18 years old (19 in NE and AZ)? Yes
No

Skills and Experience
Please list any special qualifications, training, education, skills, or experience that you feel warrant consideration by the company. (8000 characters max)


Please list any business equipment operating abilities you have which might be useful on the job for which you are applying. (8000 characters max)

Education
*Did you graduate from high school or earn a GED? Yes
No
Name and location of college, university, business or trade school
Full-time or part-time Full-time
Part-time
Major field of study
Degree conferred
Hours credit

Work Experience
Name of present or last employer
Type of business
Street Address
City
State
Dates of employment to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs (8000 characters max)
If we contact this employer, would you expect them to say they would rehire you for a position you last held there? Yes
No
If no, please explain (8000 characters max)
Employer's phone number  ex (999)999-9999   

Name of employer prior to job above
Type of business
Street Address
City
State
Dates of employment  ex.(01/01/00) to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs (8000 characters max)
If we contact this employer, would you expect them to say they would rehire you for a position you last held there? Yes
No
If no, please explain (8000 characters max)
Employer's phone number ex (999) 999-9999  

Name of employer prior to job above
Type of business
Street Address
City
State
Dates of employment ex (01/01/00) to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs (8000 characters max)
If we contact this employer, would you expect them to say they would rehire you for a position you last held there? Yes
No
If no, please explain (8000 characters max)
Employer's phone number ex(999) 999-9999

Legal
Have you ever been convicted of or pled 'No Contest' to a crime other than a routine traffic violation?* Yes
No
Plead No Contest
If Yes or No contest, date of conviction or plea ex (01/01/00)
Please explain (8000 characters max)
Conviction of a crime will not necessarily disqualify you from consideration for employment.

*Authorization
I certify that I have read and understand all parts of it and certify that I have truthfully and completely answered all questions. I understand that falsification of any of the information given herein or on any other employment form is grounds for immediate termination, regardless of when such falsifications may be discovered.

I authorize QuikTrip Corporation and its representatives to investigate my education, employment experience, criminal conviction records, and all other aspects of my background relevant to my proposed employment, including all statements made by me in my application for employment. I release QuikTrip and its representatives, as well as any person to whom such inquiry is directed, from any liability arising directly or indirectly from any such investigators.

Further, I understand that employment will be contingent upon successfully passing a pre-employment drug-screening test (except where prohibited). I understand my employment with QuikTrip Corporation is for no definite length of time. I understand my employment may be terminated at any time with or without cause, at the option of either QuikTrip Corporation or myself. I understand that no employee or representative of QuikTrip Corporation has any authority to make any agreement which is contrary to the foregoing. If accepted for employment, I agree to comply with all company policies and procedures and with all rules and regulations made known at the time of employment or any other time thereafter, and to perform all duties assigned to me to the best of my ability.
Yes
No

 

*Notice to Applicants and Employees Regarding Consumer Reports
A consumer report and/or an investigative consumer report including information concerning your character, employment history, general reputation, personal characteristics, criminal or police records, motor vehicle record, mode of living, and/or credit and indebtedness may be obtained for employment purposes at any time. An investigative consumer report is a consumer report which contains information obtained from interviews with your neighbors, friends or associates. Upon timely written request of the Personnel Department of the Company, and within 5 days of the request, the nature and scope of any investigative consumer report obtained will be disclosed to you.

Before any adverse action is taken in whole or in part as a result of information contained in a consumer report or an investigative consumer report, you will be provided a copy of the report and a summary of your rights under the Fair Credit Reporting Act.

 *Disclosure and Release
In connection with my application for employment with QuikTrip, I understand that consumer reports which may contain public record information may be requested. These reports may include the following types of information: names and dates of employment, reason for termination of employment, accidents, work experience, etc. I further understand that such reports may contain public record information concerning my driving record, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records.

You have the right, upon written request, to receive a written description of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.

I authorize, without reservation, any person or entity contacted by QuikTrip or its agent or agents to furnish the above-stated information, and I release any such person or entity from any liability for furnishing such information.
Yes
No

 

Thank you for your interest in employment at QuikTrip. Your application will be given to the Personnel Department at the QuikTrip Division Office in your area. Your qualifications and experience will be compared with the job requirements. We will contact the most qualified candidates within 15 business days.


* Required