Application for Employment

APPLICATION FOR EMPLOYMENT
(Equal Employment Opportunity Company)
Lanman Oil Company, Inc.
P.O. Box 108, Charleston, IL 61920

STORE SELECTION Please check the store to which you are applying. You may select more than one location.	Lambo’s 1, 200 West Lincoln, Charleston, IL Lambo’s 2, 1202 Charleston Ave, Mattoon, IL Lambo’s 3, 100 Miller Road, Mattoon, IL Lambo’s 5, 1000 East Southline Road, Tuscola, IL
GENERAL INFORMATION
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Name
Email
Address
Telephone
Social Security Number
Date available for employment
Have you ever been employed by this company?
Are you employed now?
May we contact your present employer?
If so, please provide contact name
Are you prevented from becoming lawfully employed in the U.S. because of visa or Immigration status?
Type of work desired
Do you have a valid driver’s license in this state?
Driver’s License Number
Can you perform the essential functions of the job(s) for which you are applying?
Date you are available to work
Have you been convicted of a felony? (Please note a “Yes” answer will not bar you from consideration for employment.)
If Yes, please explain:

EDUCATION
Elementary	High School	College	Graduate

Years Completed:
Elementary	High School	College	Graduate
Course of Study
Special Skills, Qualifications and Considerations Summarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking.

References List three (3) non-relatives who are familiar with your qualifications and work history ability.
Name	Title/Relationship	Years Known	Telephone



EMPLOYMENT EXPERIENCE Start with your present or last job. List your last four (4) jobs in order. Do not omit any job.
Employer		Supervisor’s Name
Address		Your Position
Telephone		MM/YY Start / End
Salary (Start / End)		Duties
What did you like most about your job?

Reason for leaving

Employer		Supervisor’s Name
Address		Your Position
Telephone		MM/YY Start / End
Salary (Start / End)		Duties
What did you like most about your job?

Reason for leaving?

Employer		Supervisor’s Name
Address		Your Position
Telephone		MM/YY Start / End
Salary (Start / End)		Duties
What did you like most about your job?

Reason for leaving

This company is an equal opportunity employer. All applicants will be considered without regard to age, color, national origin, religion, disability, sex, or other protected status in accordance with applicable federal and state equal employment opportunity laws. This company will strive to accommodate any physical or mental limitations of employees or applicants in order to accomplish the essential functions of the job.