TravelCenters of America LLC

Employment Application

Hourly Applicants

Please apply online at www.myTAjob.com or by calling 1-888-6-MY-TA-JOB (1-888-669-8256).

Application Form For Management Positions

Thank you for your interest in joining our TravelCenters of America team. At TA, energetic empoliyees are key contributors to the excptional service we provide our guests. Prior to hiring, all new employees are required to complete an assessment of personatility traits to ensure that there is a good match for the position you are interested in. We do not discriminate on the basis or race, religion, veteran status, color, sex, age, national origin or disability. If you are a team-oriented and guest-focused individual who enjoys an energetic work environment that features the latest trends in technology in retail merchandising, food preparation and store cleanliness, then TravelCenters of America is the place for YOU!

Employment Application:

For what job are you applying?
Location:

Social Security Number:
First Name: Middle Initial:	Last Name:
Address:
City:
State: Zip:
Home Phone: Cell Phone:	Email:

Are you 18 or over?:	YesNo	If no, give age:
Can you at the time of employment submit verification of your legal right to work in the U.S.?:			YesNo
Starting wage expected:

Please tell us about your availability:
Your desired hours of availability may impact your schedule. Certain positions require flexibility in hours worked.

Anytime:	YesNo	Evenings:	YesNo
Weekdays	YesNo	Overnight:	YesNo
Weekends:	YesNo	Holidays:	YesNo

Now that you've told us your availability to work, when do you really WANT to work?

Day	From	To	Day	From	To
Sunday			Thursday
Monday			Friday
Tuesday			Saturday
Wednesday

Education:

	Name of School, City and State	Major	Did you graduate?	Grade Average
High School	Name: City: State:		YesNo
Vocational Schools, Business Schools, Other	Name: City: State:		YesNo
Vocational Schools, Business Schools, Other	Name: City: State:		YesNo
Colleges or Universities	Name: City: State:		YesNo
Colleges or Universities	Name: City: State:		YesNo

Employment History:
Instructions: Beginning with the last or present employer, list all employers for whom you have worked, whether full-time or part-time.

Employed From (Mo./Yr.)	To (Mo./Yr.)
Name of Employer
Address
Phone (with area code)
Supervisor's Name
Supervisor's Title
Base Salary	or Hourly Rate
Hours Per Week
Reasons for leaving
Job Title
Job Duties

Employed From (Mo./Yr.)	To (Mo./Yr.)
Name of Employer
Address
Phone (with area code)
Supervisor's Name
Supervisor's Title
Base Salary	or Hourly Rate
Hours Per Week
Reasons for leaving
Job Title
Job Duties

Employed From (Mo./Yr.)	To (Mo./Yr.)
Name of Employer
Address
Phone (with area code)
Supervisor's Name
Supervisor's Title
Base Salary	or Hourly Rate
Hours Per Week
Reasons for leaving
Job Title
Job Duties

General Information:

How did you hear about TravelCenters of America?

Have you ever been employed by this company?	YesNo
If yes, list location
Dates of Employment
In some positions, at times you may be required to drive a company vehicle. Do you have a valid driver's license?	YesNo
If yes, please list license number.
State
*Within the last seven years have you ever been convicted of, pled guilty to, or pled no contest to a felony, a crime involving dishonesty, or a crime involving violence to another person?	YesNo
If yes, describe in full: * A conviction will not necessarily bar you from employment.
Additional comments you feel are important to the consideration of your application
I am applying for a position with TravelCenters of America. If I am employed, I agree that my employment with the Company is at the will of the Company, which means that the Company has the right to discharge me for any reason or no reason with or without notice. I also understand that I may be terminated or laid off at the discretion of the company. I expressly agree and understand that this is the entire agreement between the Company and myself on the subject of discharge, termination and/or layoff, and it may be changed only by an agreement in writing, signed by the President of the Company. I agree to conform to the Company rules, and I also agree that I shall be subject to other conditions which the company may adopt at its sole discretion. I affirm that the information on this application is true and complete, and that intentional deception herein will result in disqualification or dismissal if employed. In connection with my application for employment, I understand that as a precondition to obtaining employment at TravelCenters of America, I must successfully complete a pre-employment test for drug and/or alcohol by testing negative through urinalysis or a similar test administered to detect the use or abuse of drugs and/or alcohol. I understand that I may be required to sign a confidentiality statement upon being employed by TravelCenters of America. In connection with my application for employment, I understand that a thorough credit and background check may be made. I hereby authorize an educational institution, past or present employer, law enforcement agency or any person who has knowledge of my education, work experience and/or criminal conviction record to release this information to TravelCenters of America or its agents. I hereby release all persons from liability as a result of providing true, accurate information. Read Carefully before Accepting. I agree that any lawsuit relating to my service with TravelCenters of America or any of its subsidiaries must be filed no more then six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I wave any statute of limitations to the contrary.
I have read and accept the terms above.	YesNo

Attach resume: