Employment Application

Circle K Management LLC * Payless Fuel Centers of Texas LLC * Lone Star Property Management LP * St George & AVA TGI * St Mary & AVA Mena Inc * Riverside Fuel & Food LLC * S&M Fast Food * Chicken & Fish Depot LLC * North Texas Taco Casa

Please fill out the form to complete the Employment Application:

    EMPLOYMENT APPLICATION

    Date of Hire:
    Date of Birth:
    State:
    PLEASE PLACE A CHECK BY YOUR RESPONSE OR PROVIDE THE APPROPRIATE INFORMATION

    Are you interested in:
    What schedule would you prefer?
    How did you hear about the position?

    Desired Pay (Fill the choices that are applicable):

    When are you able to start work? Date:

    In what local area do you prefer to work?
    Position desired:
    PLEASE CHECK YES OR NO TO THE FOLLOWING:

    Are you authorized to work in the United States?

    Federal law requires that employers hir e only individuals who are authorized to be lawfully employed in the United States. In compliance with these laws Circle K Management L LC Payless Fuel Centers o f Texas L LC * Lone Star Property Management L P St George & Ava T GI St Mary & Ava Mena Inc Riverside Fuel & Food L LC * S&M Fast Food Chicken & Fish Depot L LC * North Texas Taco Casa I will verify the status of every individual offered employment with the Company. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit su ch documents as are required by law to verify your identification and employment authorization.

    Are you under 18 years of age?

    If yes, can you furnish a work permit?

    Are you capable of performing the essential functions of the job for which you are applying with or without a reasonable accommodation?

    PLEASE LIST YOUR WORK EXPERIENCE BELOW (MOST RECENT JOB FIRST)

    Most Recent Job

    Termination
    2nd Most Recent Job

    Termination
    3rd Most Recent Job

    Termination

    EDUCATION:

    Name And Address of School
    Major/Subject
    Did You Graduate?
    Type of Degree
    High School Or Prep
    College
    College or Graduate
    Other

    PROFESSIONAL DESIGNATIONS:

    PROFESSIONAL LICENSES:

    REFERENCES: (Please list three professional references)

    PLEASE READ CAREFULLY BEFORE SIGNING APPLICATION

    I have submitted the attached form to the company for the purpose of obtaining employment. I acknowledge that the use of this form, and my filling it out, does not indicate that any positions are open, nor does it obligate the company to further process my application.
    My signature below attests to the fact that the information that I have provided on my application, resume, given verbally, or provided in any other materials, is true and complete to the best of my knowledge and also constitutes authority to verify any and all information submitted on this application. I understand that any misrepresentation or omission of any fact in my application, resume or any other materials, or during any interviews, can be justification for refusal of employment, or, if employed, termination from the Company’s employ.

    I also affirm that I have not signed any kind of restrictive document creating any obligation to any former employer that would restrict my acceptance of employment with the Company in the position I am seeking. I understand that this application is not an employment contract for any specific length of time between the Company and me, and that in the event I am hired, my employment will be “at will” and either the Company or I can terminate my employment with or without cause and with or without notice at any time. Nothing contained in any handbook, manual, policy and the like, distributed by the Company to its employees is intended to or can create an employment contract, an offer of employment or any obligation on the Company’s part. The Company may, at its sole discretion, hold in abeyance or revoke, amend or modify, abridge or change any benefit, policy practice, condition or process affecting its employees. References: I hereby authorize the company and its agents to make such investigations and inquiries into my employment and educational history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquires connected with my application and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities listed by me in this form. Furthermore, I authorize the company and its agents to release any reference information to clients who request such information for purposes of evaluating my credentials and qualifications.

    Temporary/Contract Employment: If employed as a temporary or contract employee, I understand that I may be an employee of the company and not of any client. If employed, I further understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason. I further understand that a contract will exist between the company and each client to whom I may be assigned which will require the client to pay a fee to the company in the event that I accept direct employment with the client, I agree to notify the company immediately should I be offered direct employment by a client (or by referral of the client to any subsidiary or affiliated company), either for a permanent, temporary (including assignments through another agency), or consulting positions during my assignment or after my assignment has ended.

    Date:

    Background Check Authorization

    Circle K Management LLC * Payless Fuel Centers of Texas LLC * Lone Star Property Management LP * St George & AVA TGI * St Mary & AVA Mena Inc * Riverside Fuel & Food LLC * S&M Fast Food * Chicken & Fish Depot LLC * North Texas Taco Casa
    Background Check Information and Consent

    The information contained in this application is correct to the best of my knowledge. I hereby authorize the company and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit reports, current and previous residences, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any public records.

    I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to DFW Oil & Energy LLC or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources DFW Oil & Energy LLC and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth.

    Date:

    License

    Cover Letter

    Resume

    Acknowledgement of Arbitration And Alcohol Test Form

    Cigarette Notification Acknowledgement Form

    Direct Deposit Payroll ADP Form

    Employee Work Injury Policy Acknowledgement Form

    General Employment Operations Policies Acknowledgement Form

    Restricted Sales Consumption Acknowledgement Form

    Team Member Handbook Acknowledgment Form

    Work Related Injury Reporting Requirements Form

    USCIS I-9 Form

    W4 Form

    Additional Information (optional)