Employment – Farmer's Union Oil Co Travel Center

Employment Positions

Applicant Name:(Required)

First Last

Other Phone:(Required)

Home Phone:(Required)

Email Address:(Required)

Enter Email Confirm Email

Current Address:(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

How were you referred to Farmers Union Company?(Required)

If there has been a gap in employment of more than 6 months, please provide details below. (Attach sheet if more space is needed)

References

List below two (2) persons who have knowledge of your work performance within the last four (4) years. Please include professional references only.

Name:

First Last

Phone Number:

Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Occupation:

Number of Years Acquainted:

Name:

First Last

Phone Number:

Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Occupation:

Number of Years Acquainted:

Please Read and Initial Each Paragraph, then Sign Below

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure employment can be grounds for rejection of application or, if I am employed by Farmers Union Oil Company, terms for my immediate expulsion from Farmers Union Oil Company.(Required)

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or Farmers Union Oil Company.(Required)

I permit Farmers Union Oil Company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release Farmers Union Oil Company, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation.(Required)

Applicant's Signature:(Required)

Date:(Required)

EMPLOYMENT OPPORTUNITIES

Employment Positions

Employment Positions

Personal Information

Education, Training, and Experience

High School

College / University

Vocational School

Military

Additional Information

Employment History

References

Please Read and Initial Each Paragraph, then Sign Below

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