Employment Application We’re glad you’re interested in a job at EZ Stop.Fill out the following form to start the application process. Personal Information First Name * Middle Name Initial Last Name * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone Number * (###) ### #### Preferred Method of Contact * Phone Call Text Message Job Information Position Applying For * Sales Associate (Part Time) Sales Associate (Full Time) Store Manager Stock Clerk/Baskin Robins Clerk Corporate Office Roles Other Expected Hourly Pay in Dollars * How did you learn about EZ Stop? * Availability For each day, list hours you'd be available to work, e.g. "9am – 5pm" Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays Have you ever worked for EZ Stop? * Yes No If so, list dates, location, and manager's name. Were you referred by a current employee? * Yes No If yes, whom? Do you have any relatives/friends currently working for the company * Yes No If yes, whom and what is their relationship to you? If yes, at what location do they work? Background Are you 18 years of age or older? * Yes No Have you ever been terminated or asked to resign? * Yes No If so, why? Have you ever been convicted of a felony or misdemeanor? * Please note the existence of a criminal history will not automatically disqualify you from the job you are applying for. Yes No If so, please explain: If so, in what city and state did you commit? If so, what date did you commit? MM DD YYYY Current and/or Recent Employment Employer #1 Employer Type * Current Employer Previous Employer No Previous Employment Business Name Business Address Business Phone Number (###) ### #### From To Position Title & Duties Salary $ Name of Supervisor Reason for leaving Employer #2 Employer Type Current Employer Previous Employer Business Name Business Address Business Phone Number (###) ### #### From To Position Title & Duties Salary Name of Supervisor Reason for leaving Employer #3 Employer Type Current Employer Previous Employer Business Name Business Address Business Phone Number (###) ### #### From To Position Title & Duties Salary Name of Supervisor Reason for leaving Personal References Personal Reference #1 No former employers or relatives Name * City, State * Occupation * Phone Number * (###) ### #### Personal Reference #2 No former employers or relatives Name * City, State * Occupation * Phone Number * (###) ### #### Personal Reference #3 No Former Employers or Relatives Name * City, State * Occupation * Phone Number * (###) ### #### Education Highest Level of Education Achieved Name of School * Years Attended * Last Completed Year * Did you graduate? Yes No Diploma/Degree Achieved Certifications and Licenses Do you have any certifications/licenses related to the position you are applying to? Yes No Certification or License Type and Description Effective Date of Certification or License MM DD YYYY Expiration Date of Certification or License MM DD YYYY IMPORTANT: Read Before Submitting I certify that information given herein is true and complete to the best of my knowledge. I understand that incorrect, misleading or incomplete information on this application may result in immediate termination of employment. I understand that this employment application and any other company documents are not contracts of employment and that any individual who is hired may voluntarily leave employment upon proper notice and may be terminated by the employer at any time and for any reason. I also understand that any oral or written statements to the contrary are expressly disavowed and should not be relied upon by any prospective or existing employee. I understand that the use of illegal drugs is prohibited during employment. I understand that EZ Stop is a drug free workplace and at any time as an employee of the company I can be selected for random, reasonable cause, post-accident drug testing to detect the use of illegal drugs. Thank you!
