Dowdle Gas & Appliance Center

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If you would like to apply for a job with Dowdle Butane Gas Co., Inc., please complete the form below or click here for a printable copy that can be mailed to: P.O. Box 9129, Columbus, MS 39705.

Personal Information:
	Social Security Number:
	Name:	First:
		Middle:
		Last:

	Present Address:
		Street:
		City:
		State:
		Zip:

	Permanent Address:
		Street:
		City:
		State:
		Zip:
	Phone:
	Email:
	Referred by:
	Are you 18 years of age or older? Yes No

Employment Desired:
	Position:	Manager Route Salesman CSR Service Technician
	Date you can start:
	Salary Desired:
	Are you employed now? Yes No
	If so, may we inquire of your present employer? Yes No
	Ever Applied to this Company before? Yes No
	Where?
	When?

Education:

	Name and Location of School	Last Year Completed	Did you Graduate

Grammer School:			Yes No

High School:	Subjects Studied and Degree(s) earned:	1 2 3 4	Yes No

College:	Subjects Studied and Degree(s) earned:	1 2 3 4	Yes No

Other:	Subjects Studied and Degree(s) earned:	1 2 3 4	Yes No

General:
	Subjects of Special Study or Research:
	Job Related Skills:
	Activities Other than Religious:

Former Employers: List Previous four employers.
1.	From: To:	Name & Address
		Ending Salary
		Position
		Reason for Leaving

2.	From: To:	Name & Address
		Ending Salary
		Position
		Reason for Leaving

3.	From: To:	Name & Address
		Ending Salary
		Position
		Reason for Leaving

4.	From: To:	Name & Address
		Ending Salary
		Position
		Reason for Leaving

References: List three persons not related to you that you have known at least one year.
1.	Name:
	Address:
	Position:
	Years Acquainted:

2.	Name:
	Address:
	Position:
	Years Acquainted:

3.	Name:
	Address:
	Position:
	Years Acquainted:

Authorization: By submitting this form...I authorize investigation on all statements contained in this application. I understand that misrepresentation of information requested is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without case and without any previous notice.