Employment Application Form
THRIFTY EXPRESS LOANS, L.L.C.

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE			
APPLICATION FOR EMPLOYMENT	
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS	
	
PLEASE COMPLETE PAGES 1-5.	DATE 		
Name 		
	Last 			First 			Middle 			Maiden	
Present address 		
			Number			Street		City	State	Zip	
How long 		Social Security No. _______ –  _____  –  _________	
Telephone (      )		
If under 18, please list age 		

Position applied for  (1)	
and salary desired   (2) 	
(Be specific)	Days/hours available to work
No Pref 	 Thur 	
Mon 	  Fri 	
Tue 	  Sat 	
Wed 	  Sun 		
How many hours can you work weekly? 	  Can you work nights? 		
Employment desired	FULL-TIME ONLY	  PART-TIME ONLY	    FULL- OR PART-TIME	
When available for work?	 
Do you have a valid driver’s license:     Yes     No          Expiration Date _______________
Do you have automobile insurance:     Yes     No         Expiration Date _______________
Must be a licensed driver with personal transportation and proof of insurance.	

TYPE OF SCHOOL	NAME OF SCHOOL	LOCATION
(Complete mailing address)	NUMBER OF YEARS COMPLETED	MAJOR & DEGREE	
High School					
					
College					
					
Bus. or Trade School					
					
Professional School					

HAVE YOU EVER BEEN CONVICTED OF A CRIME?	 No		 Yes	
If yes, explain number of  conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. 		

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE			
APPLICATION FOR EMPLOYMENT	
	
DO YOU HAVE A DRIVER’S LICENSE ?	 Yes	 No  	
What is your means of transportation to work? 		
Driver’s license 
number 	 State of issue _______         Operator      Commercial (CDL)     Chauffeur	
Expiration date 	 Car Insurance Expiration date___________________	
Have you had any accidents during the past three years?	How many? 		
Have you had any moving violations during the past three years?	How Many? 		
	OFFICE ONLY		
	
	 Yes					 Yes		Word		 Yes
Typing	 No	   _____ WPM		10-key  	 No		Processing	 No	     _____ WPM	
Personal 	 Yes 	PC	 		
Computer	 No	Mac	 			Other 	
Skills 		
	
Please list two references other than relatives or previous employers.	
Name 		Name 		
Position 		Position 		
Company 		Company 		
Address 		Address 		
						
Telephone  (      )		Telephone  (      )		
	
An application form sometimes makes it difficult for an individual to adequately summarize a complete background.  Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.	

	

	

	

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE			
APPLICATION FOR EMPLOYMENT	
	MILITARY		
	
HAVE YOU EVER BEEN IN THE ARMED FORCES?		 Yes	 No	
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?		 Yes	 No	
Specialty 	 Date Entered 	 Discharge Date 		
	
Work Experience	Please list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name.  Attach additional sheets if necessary.	
		
Name of employer 
Address	Name of last supervisor	Employment dates	Pay or salary	
City, State, Zip Code
Phone number		From
To	Start
Final	
	Your last job title	
Reason for leaving (be specific)	
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	

Name of employer 
Address	Name of last supervisor	Employment dates	Pay or salary	
City, State, Zip Code
Phone number		From
To	Start
Final	
	Your Last Job Title	
Reason for leaving (be specific)	
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE			
APPLICATION FOR EMPLOYMENT	
Work experience	Please list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name.  Attach additional sheets if necessary.	
		
Name of employer 
Address	Name of last supervisor	Employment dates	Pay or salary	
City, State, Zip Code
Phone number		From
To	Start
Final	
	Your last job title	
Reason for leaving (be specific)	
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	

Name of employer 
Address	Name of last supervisor	Employment dates	Pay or salary	
City, State, Zip Code
Phone number		From
To	Start
Final	
	Your last job title	
Reason for leaving (be specific)	
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	

	
May we contact your present employer?	 Yes	 No	
Did you complete this application yourself	 Yes	 No	
If not, who did? 		

PLEASE READ CAREFULLY	

APPLICATION FORM WAIVER
	
In exchange for the consideration of my job application by ___________________ (hereinafter called “the Company”), I agree that:
Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of                         , or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company.  Both the undersigned and                         may end the employment relationship at any time, without specified notice or reason.  If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.	
I authorize investigation of all statements contained in this application.  I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.  I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.	
I also understand that (1) the Company has a drug and alcohol policy that provides for preemployment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy.  I further understand that continued employment may be based on the successful passing of job-related physical examinations.	
I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living.  Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.	
I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.	

Signature of applicant__________________________________________ Date: ___________________ 

This Company is an equal employment opportunity employer.  We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability.  We assure you that your opportunity for employment with this Company depends solely on your qualifications.
	
	Thank you for completing this application form and for your interest in our business.