Retail Gas Station Employment Application

Please fill out the following application if you are interested in working for one of our Retail Gas Stations. If you prefer to fill out and submit a PDF version you can download that here and submit it as directed at the top of that page.

Please Note: We may refuse to hire relatives of present employees if doing so could result in actual or potential problems in supervision, security, safety, or morale, or if doing so could create conflicts of interest.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Your Name*

First Middle Last

Present Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Employment Desired

Position applying for*

Personal Information

How did you hear about our company and this job opening?*

Have you ever applied to or worked for this position before?*

Yes

When?*

Why are you applying for work at Napa Valley Petroleum?*

If hired, would you have a reliable means of transportation to and from work?*

Yes

Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.)*

Yes

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?*

Yes

Describe the functions that cannot be performed.*

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

Education, Training, and Experience

High School Name*

High School Address*

Street Address Address Line 2 City State ZIP Code

# of Years Completed*

Did you Graduate?*

Yes

Degree / Diploma*

College / University Name*

College / University Address*

Street Address Address Line 2 City State ZIP Code

# of Years Completed*

Did you Graduate?*

Yes

Degree / Diploma*

Vocational / Business School Name*

Vocational / Business School Address*

Street Address Address Line 2 City State ZIP Code

# of Years Completed*

Did you Graduate?*

Yes

Degree / Diploma*

Health Care Training Name*

Health Care Training Address*

Street Address Address Line 2 City State ZIP Code

# of Years Completed*

Did you Graduate?*

Yes

Degree / Diploma*

Employment History

List below all present and past employment starting with your most recent employer (last five years is sufficient). You must complete this section even if attaching a resume.

Name of Employer*

Phone*

Type of Business*

Your Supervisor's Name*

Employer Address*

Street Address Address Line 2 City State ZIP Code

Employment Start Date

Employment End Date

Is this your current employer?*

Yes

Your Position and Duties*

Reason for Leaving*

May we contact this employer for a reference?*

Yes

Name of Employer #2

Phone

Type of Business

Your Supervisor's Name

Employer #2 Address

Street Address Address Line 2 City State ZIP Code

Employment Start Date

Employment End Date

Your Position and Duties

Reason for Leaving

May we contact this employer for a reference?

Yes

Upload Resume or Additional Employment (Optional)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 2.

References

List below three persons not related to you who have knowledge of your work performance within the last three years.

Name*

First Last

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Occupation*

No. of Years Acquanted*

Name*

First Last

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Occupation*

No. of Years Acquanted*

Name*

First Last

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Occupation*

No. of Years Acquanted*

Consents

Please Read Carefully, Tick Each Box to Agree and Sign Below

Napa Valley Petroleum will consider qualified applicants, including those with criminal histories, in a manner consistent with state and local "Fair Chance" laws.

Signature Date*

Applicant's Signature*

Retail Gas Station Employment Application

Employment Desired

Personal Information

Education, Training, and Experience

Employment History

References

Consents

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