Minit-Mart/Minits Application for Employment

Date: ____________________ Desired Position: ____________________________ Name: ____________________________________ Date of Birth: ______________________________ Phone No.: ________________________________ Email: _________________________________________

Address:______________________________________________________________________________ Street Address City State Zipcode Country

1. What Days of The Week Can You Work: _______________________________________________

2. What hours are you available to work? ________________________________________________

3. Is there anything that would keep you from lifting 50lbs or more:

___________________________________________________________________________________

4. Have you ever had any relatives or friends work for the company? _____

If you answered 'Yes' to Question 3. Who? Do you know which position they held?

____________________________________________________________________________________

Employment Questions:1. Are you over 18? ____________

2. Which City Are You Applying For? _________________________________

3. Desired Hourly Salary? _______________________

4. Date you can start? ________________________

5. Are you currently Employed? _________

6. Have You Ever applied or worked for Minit-Mart or Minits Before? _________a. If 'Yes' Which One? Where? and When?

___________________________________________________________

7. Are You currently laid off or subject to recall?_____

8. Will you work overtime if required?_______

Please Answer These Questions Truthfully

Highest Education: _______________________

School Address: ______________________________________________________________________Street Address City State Zip Code Country

Employment Record for the Past 5 Years: Most Recent Employer Name: ___________________________________

Position Held: _____________________________

Reason for Leaving: ______________________________________________________________

Supervisors Name: _____________________________ Phone No: _________________________

Employer Name: ___________________________________

Position Held: _____________________________

Reason for Leaving: ______________________________________________________________

Supervisors Name: _____________________________ Phone No: _________________________

Employer Name: ___________________________________

Position Held: _____________________________

Reason for Leaving: ______________________________________________________________

Supervisors Name: _____________________________ Phone No: _________________________

Employer Name: ___________________________________

Position Held: _____________________________

Reason for Leaving: ______________________________________________________________

Supervisors Name: _____________________________ Phone No: _________________________

From: _______ to _________

From: _______ to _________

From: _______ to _________

From: _______ to _________

• Do you have any C-Store Experience? ______o If 'Yes' How Long?____________

• Do you have any Quick Service Restaurant or Restaurant Experience?______o If 'Yes' How Long?___________

• Do you have your "Safe Serve Certification" for food handling? _____

• Do you have your "Alcohol Seller Certification" for selling alcohol?_____

• What was the longest job you've had & why did you leave?

• What was the Shortest you've had & why did you leave?

• We check references. When we check yours, how much notice will your last3 employers say you gave?

o Employer: _____________ | Notice Given: _____________

o Employer:______________ | Notice Given: _____________

o Employer:______________ | Notice Given: _____________

• Are you bilingual if so what languages do you speak?

• If we needed you to come to work on a moments notice could you? ______If no, list reasons why not:

• How would you prevent a personHow would you prevent a person from putting gas in theirfrom putting gas in their car car and driving offand driving off without paying for it?without paying for it?

• If you saw a customer put something into their pocket, what would you do?

• What do you think customers want most from a business and employees like ours?

• While in the food prep area we require all our employees to wear hair nets,keep fingernails short, and keep hands clean at all times as well as adhere toall other health and food practices required by law.Will you honor these policies and procedures? _____

• What do you think this statement means, "we don't get paid for time; we get paid forbringing value to our jobs"?

• Would your previous supervisors say you are consistently on time? _____Why or Why Not?

• Would your previous supervisors say that your attendance was (choose one): _________ Excellent Good Fair Poor

• Would your past supervisors say you are organized? ______

• What does "being organized" mean to you?

• Was the previous company you worked for a good company? _____Please Explain.

• Was your previous employer fair in regards to pay? _____Please Explain.

• Would your previous supervisor say that you were good at following instructions?______. Please Explain.

• Would your past supervisors say you get angry (choose one) ? _________ Never Rarely Sometimes Often

• What causes you to get upset on the job?

• Please choose 3 areas in which you are the weakest:Dilligence Truthfulness Loyalty Orderliness Punctuality InitiativeEnthusiasm Alertness Availability Dependability Honesty

ANSWER:_______________________________

• Please choose 3 areas in which you are the strongest:Dilligence Truthfulness Loyalty Orderliness Punctuality InitiativeEnthusiasm Alertness Availability Dependability Honesty

ANSWER:_______________________________

• What are some of your goals and how will this job help you reach your goals?

• Why do you want to work for this company?

• Please read this carefully and understand completely:The job we have to offer is: "To do anything and everything the business requires,at any given time". This means you may at any time be asked to: Run a register, cook,wash dishes, mop the floor, take out the trash, clean the restrooms, or anything else thatneeds to be done. This may be in the c-store, QSR, laundry, outside, or anywhere elsethe business requires.Is there any type of work you are unwilling or unable to do? _________ If'Yes' Please list what and why you are unable to do it.

• We do pre-employment drug testing, random drug testing and probable suspicion drugtesting at our discretion in accordance with the law.Do you agree to be drug tested at any time? _________

Approved by: ____________________________________________________________________

To Be Completed by Supervisor

Interviewed by: ___________________________________________ Date: _________________

Hired: Yes No Position: ___________________ Dept.: _________________

Salary / Wage: _______________________ Report To: ________________ Date: __________

To Be Read & Agreed To by Applicant

In accordance with company policy, I have been informed and agree to the pre-

employment drug screening and random drug screening at the employer's discretion.This certifies that this application was completed by me, and that all entries on it and information in it are

true and complete to the best of my knowledge. As a part of the pre-employment hiring process, I further

understand that information not disclosed or falsely represented by me will result in my immediate termination.

I Agree With the Statement Above

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