Online Employment Application Form
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Instructions:
This online employment application is provided for your convenience.
If you would prefer to print off this application and fill it out, click here.
Fill out all pertinent information to the best of your knowledge. All fields listed in red are required. Your information will remain private and will not be sold or transferred to anyone outside Lassus, for any reason. |
Position Applying For:
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Store Location:
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| General Information: |
Applicants Name (last - first - middle)
Street Address
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| City |
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State |
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Zip |
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| Phone |
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Alternate Phone | |
| E-mail | |
Fax | |
| Personal Information: |
| List any friends or relatives employed by this company: |
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| Have you worked for Lassus/Handy Dandy before? |
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Yes
No |
| If yes, which location? |
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| Are you employed now? |
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Yes
No |
| May we contact your employer? |
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Yes
No |
| Name of Employer? | |
Phone |
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| Why are you looking for a career change? | |
| Date available for work: | |
| Are you on layoff or subject to recall? |
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Yes
No |
| Have you ever plead "guilty" or "no contest" to, or been convicted of a crime? |
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Yes
No |
| List 3 important qualities of customer service: |
| 1. | |
| 2. | |
| 3. | |
| Education: |
| Highest Grade Completed: 89101112GED |
| Are you currently in school? |
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Yes
No |
| Name of school? | |
| Highest year completed in college,tech or business school: |
| 12345 | Graduated? |
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Yes
No |
| Describe any special training or education you have received: |
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| Work History: |
| List present and past employment including Military beginning with the most recent. |
| 1. Employer Name: | Employment Date (MM/YY) | Last Pay Rate |
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to
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| Employer Address: | Employer Phone | Supervisor |
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| Reason for leaving: | Job duties: |
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| 2. Employer Name: | Employment Date (MM/YY) | Last Pay Rate |
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to |
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| Employer Address: | Employer Phone | Supervisor |
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| Reason for leaving: | Job duties: |
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| 3. Employer Name: | Employment Date (MM/YY) | Last Pay Rate |
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to
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| Employer Address: | Employer Phone | Supervisor |
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| Reason for leaving: | Job duties: |
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| Please list the names of two people that could recommend you for employment: |
Name
| Relationship
| Phone
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Name
| Relationship
| Phone
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| Availability: |
| Number of hours you are available to work each week: |
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| Please tell us the times you are available to work each day of the week. |
| Sunday |
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to |
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| Monday | |
to |
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| Tuesday | | to | |
| Wednesday | | to | |
| Thursday | | to | |
| Friday | | to | |
| Saturday | | to | |
In select stores, we have overnight employees.
Would you be available to work this shift? |
| Yes
No |
| If yes, which nights? | S M T W T F S |
| Agreement: |
| I understand that a consumer investigative report may be made including information as to my character, general reputation, personal characteristics, and mode of living, and that upon written request, made by me within a reasonable period of time, a complete disclosure of the nature and scope of the investigation will be supplied to me. I understand that all employees of Lassus Brothers Oil, Inc. are employees at will and that the employment relationship can be terminated at any time, with myself. I further understand that if an offer of employment is made, I will be required to submit documentation which will verify that I am a citizen or a national of the United States, an alien lawfully submitted for permanent residence, or an alien authorized to be employed in the United States. I further understand that no Supervisor, or Manager or representative of the company, other than the President, has the authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. |
| AGREE? |
| Yes
No |
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