Cheers Food & Fuel

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*Required fields

*Date:

Date Available to Begin:

Personal Information

*Full Name:

First: Middle: Last:

*Present Address:

City:

State:

Zip Code:

*Phone Number (Daytime):

*Phone Number (Evening):

E-mail Address:

*Are you 18 years or older?:

Yes No

*May we contact your previous employer?

Yes No

Employment Desired

*Select Preference:

Convenience Store Restaurant Either

Starting Pay Desired:

If restaurant, please list type of position desired:

*Specify hours available for each day of the week:

Sunday:	Start Time:	End Time:	Anytime	Not Available
Monday:	Start Time:	End Time:	Anytime	Not Available
Tuesday:	Start Time:	End Time:	Anytime	Not Available
Wednesday:	Start Time:	End Time:	Anytime	Not Available
Thursday:	Start Time:	End Time:	Anytime	Not Available
Friday:	Start Time:	End Time:	Anytime	Not Available
Saturday:	Start Time:	End Time:	Anytime	Not Available

Are you willing to work....

Evenings?

Yes No

Weekends?

Yes No

Overnights?

Yes No

Holidays?

Yes No

How many hours per week would you like to work?

Available for overtime?:

Yes No

Have you ever worked for this company before?:

Yes No

If yes, what?:

Education

*High School:

*Address:

*Years Completed:

*Course Study/Diploma:

College:

Address:

Years Completed:

Course Study/Diploma:

Post College:

Address:

Years Completed:

Course Study/Diploma:

Trade/Business/ Correspondence:

Address:

Years Completed:

Course Study/Diploma:

Please provide any additional information such as special skills, training, management experience, equipment operation or other qualifications you feel will be helpful in considering you application:

Why would you like to work for our company?:

How Would You Rate Yourself?

1=Improvement Needed 2=OK 3=Good 4=Top Performer

*Energy Level

Your sense of urgency, self-motivation, and enthusiasm.

*Communication Skills

Your ability to listen well, express ideas clearly, and accept feedback.

*Hospitality

Your natural friendliness and customer service skills.

*Reliability

Your dependability, attendance, self-discipline, and dedication.

*Personal Pride

Your appearance, hygiene, and achievement.

*Teamwork

Your cooperation with others and team spirit.

*What achievement in life are you most proud of?

*What are your personal strengths?

*What are your weakest areas?

*What are your five year goals?

*Can you perform the essential functions of this job, with or without accommodations?

Yes No

*In case of emergency, contact:

Name:
Phone:

*Do you have reliable transportation to work?

Yes No

*Do you have any friend(s) or relative(s) working for this company?

Yes No

If Yes, state their relationship and location.

Ethics

Explain your ideal of great customer service.

In your opinion, what establishment provides great customer service and why?

In your opinion, what establishment provides poor customer service and why?

If employed by Cheers Food & Fuel, how would you impact our team?

If you see a Team Member take or steal merchandise or money, how would you handle this?

Background Information

*Have you been convicted of a crime within the last 7 years?

Yes No

If yes, please explain:

Have you ever been convicted of a felony?

Yes No

Have you ever been convicted of any crime, including misdemeanors?

Yes No

Have you ever been convicted of any crime involving violence to another person?

Yes No

Have you ever been convicted of a crime involving dishonesty?

Yes No

Are you serving probation for any misdemeanor offense?

Yes No

Have you ever been counseled or disciplined for cash handling violations?

Yes No

Current and Former Employers

List the most recent one first

*Dates:

*Name, Address, and Phone Number of Employer:

*Positions Held/Responsibilities:

Were you fired?

Yes No

*Reason for leaving:

If we contact this employer, would you expect them to say they would rehire you for the position you last held there

*Dates:

*Name, Address, and Phone Number of Employer:

*Positions Held/Responsibilities:

Were you fired?

Yes No

*Reason for leaving:

If we contact this employer, would you expect them to say they would rehire you for the position you last held there

*Dates:

*Name, Address, and Phone Number of Employer:

*Positions Held/Responsibilities:

Were you fired?

Yes No

*Reason for leaving:

If we contact this employer, would you expect them to say they would rehire you for the position you last held there

References

List three individuals not related to you that you have known for at least one year.

Name:

Address:

Phone Number:

Years Acquainted:

Name:

Address:

Phone Number:

Years Acquainted:

Name:

Address:

Phone Number:

Years Acquainted:

Additional comments you feel are important for us to know (if any):

It is the intent of Golightly & Long to establish and maintain a drug and alcohol free working environment for the safety, health and well-being of its employees and the people, products and workplace with which they come in contact. To accomplish this, all employees, associates, contracted personnel and affiliated employees must submit to the Drug and Alcohol testing program as set forth in the company policy handbook:

All candidates, prior to becoming an employee of Golightly & Long, will be required to submit to a pre-employment drug screen.

* I certify that the facts contained on this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application may result in termination on my employment.

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* I understand that by submitting this form I am signing the Consent Form and agree to company background searches.

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