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Application for Employment

First Name

Last Name

Email

Birthday

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Who are you applying for?

Choose Location

Choose Location

Choose Location

Have you worked at any of our locations before? *

Yes

No

If Yes, which location(s) and when were your employed?

In case of emergency, notify:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Are you able to be employed in this country? (If hired, verification will be required by law.) *

Yes

No

What type of position are you seeking? *

Part Time

Full Time

Seasonal

Temporary

Are you able to meet the attendance requirements of this job? *

Yes

No

Have you been convicted* of a felony in the last 7 years? (*Conviction will not necessarily disqualify an applicant from employment.) *

Yes

No

How many hours are you available to work per week?

Date available to start work.

School most recently attended.

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Teacher or Counselor

Last Grade Completed

Grade Average

Sports or Activities

Graduated *

Yes

No

Company most recently worked for:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Phone

Position

Supervisor

Date From:

Date To:

Wage

Reason for leaving?

May we contact your former employer?

Yes

No

If no, why?

Reference #1

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Phone

Years Known

Reference #2

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Phone

Years Known

Thank you for applying to Zip Zone Express. We have forwarded your application to the appropriate manager.

Zip Zone Express

FAST LANE
DISCOUNT TOBACCO

1423 Riverfront Road Suite 110

Lovely, KY 41231

Phone: 606-395-5041

Fax: 606-395-5663

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