Store:* Exxpress Mart#25, 3469 Gulfway Drive, Port Arthur Exxpress Mart#1, 1745 Texas Ave, Bridge City Exxpress Mart#4, 11755 HWY 105, Beaumont Exxpress Mart#5, 1443 U.S. HWY 69, Kountze Exxpress Mart#6, 3181 Saba Ln, Port Neches Exxpress Mart#10, 2210 IH-10 South, Beaumont Exxpress Mart#11, 4095 Dowlen Road, Beaumont Exxpress Mart#12, 196 S.LHS Dr., Lumberton Exxpress Mart#14, 383 N.LHS Dr., Lumberton Exxpress Mart#15, 5710 HWY 105, Beaumont Exxpress Mart#16, 11707 US HWY 69 S. Warren Exxpress Mart#18, 2357 HWY 69, Nederland Exxpress Mart#19, 2920 Jimmy Johnson Blvd., Port Arthur Exxpress Mart#20, 3980 Eastex Freeway, Beaumont Exxpress Mart#21, 20871 HWY 62 South, Orange Exxpress Mart#23, 910 S. Major Dr., Beaumont Exxpress Mart#24, 3025 Hwy 96 Bypass, Silsbee Exxpress Mart#26, 5410 Parkway St., Groves Exxpress Mart#27, 3911 Pure Atlantic, Groves Exxpress Mart#28, 1755 East Cardinal and MLK, Beaumont Exxpress Mart#29, 1650 W. Cardinal Dr., Beaumont Exxpress Mart#30, 255 Dowlen Rd., Beaumont
Position DesiredExxpress Mart Maintenance
Salary Desired:
Date of Birth:
Social Security Number:
Full Name:
Address:
City:
State:
Telephone Number:
Email:
Have you ever worked for Tri-Con, INC?yes no
If so, when?:
How did you learn about us?Advertisement Friend Walk-In Relative Other
Please list the names of any relatives or friends employed by Exxpress Mart:
Are you over 18 years of age?yes no
If you are under 18 years of age, can you provide proof of eligibility to work?yes no
Did you receive a copy of the job description for the position?yes no
Are you physically or otherwise unable to perform the duties of the job for which you are applying?yes no
If yes, please describe (answering is voluntary and any answers will be kept confidential)
Are you currently employed?yes no
Are you legally authorized to work in the United States?yes no
On what date would you be available for work?
Availability:Full-time Part-time Shift Work Temporary
Can you travel if a job requires it?yes no
Have you ever been convicted or pled guilty or no contest to a felony offense?yes no
For purposes of employment with Exxpress Mart, "convictions" include, but are not limited to, sentenced to confinement, paid fine, time served, placed on probation (including deferred adjudication), and court-ordered restitution. City/State: Charge: Please Explain
EDUCATION
High School: Name City/State Did you graduate?yes no Degree:
College: Name City/State Did you graduate?yes no Degree:
Other: Name City/State Did you graduate?yes no Degree:
Current Certifications/Licenses Held:
EMPLOYMENT HISTORY
Current Or Most Recent Employer Name Telephone Position Dates of Employment Duties Address: Supervisor: Starting Salary: Ending Salary: Reason for leaving: May we contact your current or most recent employer for a reference?yes no
Next Previous Employer Name Telephone Position Dates of Employment Duties Address: Supervisor: Starting Salary: Ending Salary: Reason for leaving: May we contact your current or most recent employer for a reference?yes no
Next Previous Employer Name Telephone Position Dates of Employment Duties Address: Supervisor: Starting Salary: Ending Salary: Reason for leaving: May we contact your current or most recent employer for a reference?yes no
Complete the following information only if applying for a position that requires use of a vehicle while conducting company business. If hired, your information will be verified with a Motor Vehicle Report. How many traffic violations have you had during the last two years Driver's License Number State
REFERENCES
Reference 1 Name Phone Company Position Relationship Years Known
Reference 2 Name Phone Company Position Relationship Years Known
Reference 3 Name Phone Company Position Relationship Years Known
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I understand that I may be required to successfully complete a pre-employment physical examination conducted by a company-authorized physician and that I may be required to successfully pass a pre-employment drug/alcohol screening after I accept a conditional offer of employment.
Which number is smaller, 4 or 3?
