Western Energetix - Online Job Application!

Form For Employment
A Drug Free Workplace
An Equal Opportunity Employer

Name (Last, First Middle):

E-Mail Address:

Phone Number:

Present Address:

Position Applied For:

Referred By:

Names Of Friends or Relatives Employed by This Company:

Are you over 18?	Yes No
Are you employed now?	Yes No
Have you ever worked for the Company before?	Yes No
Our retail units are operated 7 days a week and up to 24 hours a day. Are you prepared to be available for work during such time with proper notice?	Yes No
If hired, do you have a reliable means of transportation?	Yes No
Can you, upon employment, submit verification of your legal right to work in this country?	Yes No
Are you bondable?	Yes No
Have you ever been convicted of a crime? (In answering this question, do not include convictions in excess of two (2) yearsold relating to possession or use of an ounce or less of marijuana, nor any misdemeanor conviction for which probation has been completed. Note: a conviction will not necessarily disqualify you from the postition applied for.)	Yes No If yes, please explain in the area below.

Education: Name of last school attended:

Previous Work History (list 4): Include position, responsibilities, and salary history.

Are you able to perform all essential functions of the job for which you are applying?	Yes No If no, explain below.
Are you able to perform all other duties of the job for which you are applying?	Yes No If no, explain below.

The area below is provided for you to explain anything regarding the above questions.