Quality Propane Employment Application
We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.
Date
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Month
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Day
Year
Date
Name
First Name
Middle Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
1. General Information
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?
Yes
No
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.)
Yes
No
2. Education and Training
What was the last high school grade completed?
ex: 12
What was the last college year completed?
ex: 4
Have you received your Masters or Doctorate? Mark all that apply?
Masters
Doctorate
n/a
Last High School Attended
High School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate high school?
Yes
No
Average Grade
College or University Attended
College / University Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Major Course Studied
Did you graduate college/university?
Yes
No
Average Grade
College / University / Other School
Technical, Vocational, Graduate, etc.
Other School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Major Course Studied
Did you graduate college/university/other school?
Yes
No
Average Grade
3. Skills
Please list any skills you have that are appropriate for the position you are applying
If required, will you work? Mark all that apply.
Rotating Shifts
Overtime
Saturdays
Sundays
Position applying for, be specific:
Salary Requirements
Note: per hour / per month
State fully why you believe you are qualified for this position.
Interests/Accomplishments: You may wish to list significant experience, interests and accomplishments gained while working as a volunteer or as a hobbyist that may be useful in the position(s) you are seeking. Names or organizations designating religion, race, etc. need not be mentioned.
Date you can start
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Month
-
Day
Year
Date
Employment History
Starting with your PRESENT or MOST RECENT EMPLOYER, list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers.
If currently employed, may we contact your employer?
Yes
No
Employer 1: Full Name of Company
Employer 1: Salary - Beginning and End
Employer 1: Employed From/To
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Month
-
Day
Year
Employed From
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Month
-
Day
Year
Employed To
Employer 1: Phone Number
-
Area Code
Phone Number
Employer 1: Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer 1: Name and Title of Supervisor
Employer 1: Title of Your Position
Employer 1: Reason for Leaving
Employer 2: Full Name of Company
Employer 2: Salary - Beginning and End
Employer 2: Employed From/To
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Month
-
Day
Year
Employed From
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Month
-
Day
Year
Employed To
Employer 2: Phone Number
-
Area Code
Phone Number
Employer 2: Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer 2: Name and Title of Supervisor
Employer 2: Title of Your Position
Employer 2: Reason for Leaving
Employer 3: Full Name of Company
Employer 3: Salary - Beginning and End
Employer 3: Employed From/To
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Month
-
Day
Year
Employed From
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Month
-
Day
Year
Employed To
Employer 3: Phone Number
-
Area Code
Phone Number
Employer 3: Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer 3: Name and Title of Supervisor
Employer 3: Title of Your Position
Employer 3: Reason for Leaving
Employer 4: Full Name of Company
Employer 4: Salary - Beginning and End
Employer 4: Employed From/To
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Month
-
Day
Year
Employed From
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Month
-
Day
Year
Employed To
Employer 4: Phone Number
-
Area Code
Phone Number
Employer 4: Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer 4: Name and Title of Supervisor
Employer 4: Title of Your Position
Employer 4: Reason for Leaving
Signature
*
Clear
Date
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Month
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Day
Year
Date
Submit
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