All applicable sections of this application must be completed prior to consideration for employment with R. B. Stewart Petroleum Products, Inc. All information requested on this form is used solely to evaluate your ability to perform the job for which you are applying. It is the policy of RBS not to discriminate in any way against any applicant, or any employee, because of race, color, religion, sex, age, national origin, ancestry, marital status, disability (unrelated to ability to perform essential job functions), sexual orientation, genetic information, veteran status, or any other protected characteristic in accordance with federal and state laws. RBS is an Equal Opportunity Employer.

Name (First Middle Last)
Today's Date
Position sought:
Personal email:
Home Telephone
How were you referred to RBS(agency, employee, friend, newspaper, ect)?
Are any of your friends or relatives employed by RBS?
List any friends or relatives working for RBS:
Can you, after employment, submit verification of your legal right to work in the United States?
Are you at least eighteen (18) years of age?
If hired, can you furnish proof of age?
Type of Employment desired:
Date available:
Will you work shifts?
Will you work alternating shifts?
Will you work on weekends?
If no to any of the previous,
what hours will you work?
Have you ever been convicted, pled guilty, received deferred adjudication, or pled no contest to a felony or other criminal matter (including DWI or traffic offense other than non-injury traffic or parking)?

If yes, please explain. A response does not automatically exclude you from employment and will be considered only as it relates to your fitness to perform in the position for which you are applying.
Select Highest Year Completed
Grade School
High School 9
Trade School

Level Name and Location (City, State) Course or Major Graduated?
High School