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.	Lambos 1, 200 West Lincoln, Charleston, IL Lambos 2, 1202 Charleston Ave, Mattoon, IL Lambos 3, 100 Miller Road, Mattoon, IL Lambos 5, 1000 East Southline Road, Tuscola, IL
GENERAL INFORMATION
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Name:
Email:
Address:
Telephone:
SSN:
Date available for employment:
Have you ever been employed by this company:
Are you employed now:
May we contact your present employer:
If yes, give name:
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?:
Type of work desired:
Do you have a valid driver�s license in this state?:
License No.:
Can you perform the essential functions of the job(s) for which you are applying?:
Are you available to work:
Have you been convicted of a felony? (Please note that �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/YYYY started / ended
Salary (Start/End)
What did you like most about your job?
Reason for leaving?
Employer		Supervisor's Name
Address		Your Position
Telephone		MM/YYYY started / ended
Salary (Start/End)
What did you like most about your job?
Reason for leaving?
Employer		Supervisor's Name
Address		Your Position
Telephone		MM/YYYY started / ended
Salary (Start/End)
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.