Lone Star Convenience Stores - Employment Opportunities

Lone Star Pre-Employment Form

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disabilities, or any other protected group status.

Required Fields (*)

Personal Information
* Name (First, Middle, Last):
Address:
City:
State:	Zip:
Phone:
Best Time to Contact at Home:
* Email:

Employment Information
Have you ever worked for Lone Star before?	Yes No
If Yes, when?
Are you currently employed?	Yes No
If Yes, may we contact your current employer?	Yes No
Are you currently on "lay-off" status and subject to recall?	Yes No
Who referred you to Lone Star?
Are you available to work:	Full-Time Part-time Temporary
For Full-Time, please indicate which shift (1st, 2nd, or 3rd)
For Part-Time, please indicate Morning, Afternoon, or Evening
For Temporary, please indicate dates available.	Start End
Can you travel if job requires it?	Yes No

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Employment History
Most Recent Employer	Employer:
Address:
City:
State:		Zip:
Phone:
Dates Employed:		Start Date End Date
Hourly Wage/Salary (Starting/Final)		Starting Final
Job Title:
Supervisor:
Work Performed:
Reason for Leaving:

Employer 2	Employer:
Address:
City:
State:		Zip:
Phone:
Dates Employed:		Start Date End Date
Hourly Wage/Salary (Starting/Final)		Starting Final
Job Title:
Supervisor:
Work Performed:
Reason for Leaving:

Employer 3	Employer:
Address:
City:
State:		Zip:
Phone:
Dates Employed:		Start Date End Date
Hourly Wage/Salary (Starting/Final)		Starting Final
Job Title:
Supervisor:
Work Performed:
Reason for Leaving:

Employer 4	Employer:
Address:
City:
State:		Zip:
Phone:
Dates Employed:		Start Date End Date
Hourly Wage/Salary (Starting/Final)		Starting Final
Job Title:
Supervisor:
Work Performed:
Reason for Leaving:

Employer 5	Employer:
Address:
City:
State:		Zip:
Phone:
Dates Employed:		Start Date End Date
Hourly Wage/Salary (Starting/Final)		Starting Final
Job Title:
Supervisor:
Work Performed:
Reason for Leaving:

Education
Elementary School	Name:
City:		State:
High School	Name:
City:		State:
Highest Grade Completed:
College	Name:
City:		State:
Course of Study:
Highest Degree Attained:

References
Reference 1	Name:
Address:
City:
State:		Zip:
Phone:

Reference 2	Name:
Address:
City:
State:		Zip:
Phone:

Reference 3	Name:
Address:
City:
State:		Zip:
Phone:

Star Companies
P.O. Box 2067 ·· 3201 E. Highland
Jonesboro, AR 72401 ·· 866.413.7827
info@starcompanies.net

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