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Employment Application
personal information
Name
Street Address
City
Zip
Telephone Number
If under 19 years of age, give date of birth
YES
NO
In case of emergency, notify the following person
Are you related to anyone employed at Reif Oil Company?
YES
NO
Do you have the legal right to live and work in the USA?
YES
NO
Are you willing to take a written attitude survey or a urinalysis drug test now or in the future ?
YES
NO
List all convictions or place of guilty, no contest, or nolo contendere for breaking the law that you have received(include misdemeanor convictions).
Date
Violation
Disposition
Court Location
Lifting of item up to 35 lbs. may be required in the course of your employment. Are you able to do so?
YES
NO
Constant physical activity (assisting customer, stocking shelves, cleaning, store, etc.) is necessary. Are you able to be physically active the entire shift?
YES
NO
employment interest
Position for which you are applying:
Salary expected:
Date available to work
Full-time
Regular
Part-time
Temporary
Do you have reliable transportation to report to work as scheduled?
YES
NO
Please indicate days and hours which you will work.
MONDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
TUESDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
WEDNESDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
THURSDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
FRIDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
SATURDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
SUNDAY:
Start
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
End
1:00am
2:00am
3:00am
4:00am
5:00am
6:00am
7:00am
8:00am
9:00am
10:00am
11:00am
12:00pm
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00am
EDUCATION
School/College
Name and Location
Last Grade or Leave Completed
Diploma or Degree
Course of Study
Employment History
Company and Address
Type of Business
SALARY
DATE
Job Title
Supervisor
Duties and Responsibilites
Reason for Leaving
May we contact employer?
YES
NO
Telephone Number
-
+
application for employment &
agreement of employment to and with reif oil company
Unconditional Release
Equal opportunity employer M/F/H/V
(Application please read carefully)
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