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Application for Employment

We do not discriminate on the basis of race, color, religion, national origin, sex, age 40 and over, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decision be based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

    Date of Application*
    Position Applied For:*
    Store applying at:*
     
    How Did You Learn About This Position*

    PERSONAL INFORMATION

    Last Name*
    Middle
    First*
    Street Address*
    Number/Street/Apartment
    City*
    State*
    Zip Code*
    Telephone*
    Email*
    Are you 18 years of age or older?*
    (If hired, you may be required to provide proof of age)
     
    Date you are available to start work:*
     
    For driving jobs only: Do you have a valid driver's license?
     
    Are you available to work:*
     

    SKILLS & EXPERIENCE

    (Check all that apply)*
    Fluency in Foreign Languages:*
    List any other relevant qualifications you have that can be a benefit in this position:

    EDUCATION

    High School*
    Name & Location
    Years Completed
    Diploma received?
    College
    Name & Location
    Years Completed
    Diploma received?
    Grade School
    Name & Location
    Years Completed
    Diploma received?
    Other
    Name & Location
    Years Completed
    Diploma received?
    Were you in the U.S. Armed Forces?*
     

    EMPLOYMENT HISTORY

    Give names and addresses of all previous employers. If you are now working, your present employer and reason you want to leave must be included. Additional sheets may be uploaded of required.
    Employer (Latest first)*
    Employer Name
    Address
    Telephone #
    Start Date
    End Date
    Supervisor* | May we contact?
     
    Position, Duties and Responsibilities*
    Reason for Leaving (If applicable)
    Employer #2
    Employer Name
    Address
    Telephone #
    Start Date
    End Date
    Supervisor* | May we contact?
     
    Position, Duties and Responsibilities*
    Reason for Leaving (If applicable)
    Employer #3
    Employer Name
    Address
    Telephone #
    Start Date
    End Date
    Supervisor* | May we contact?
     
    Position, Duties and Responsibilities*
    Reason for Leaving (If applicable)
    Additional Information may be uploaded if required*
    OTHER INFORMATION
    Please include any other information you think would be helpful to us in considering you for employment, such as additional work experience, work skills, activities, accomplishments, etc. (You may exclude all information indicative of age, sex, race, religion, color, national origin, handicap, political belief and marital status.)
    Please list 3 professional references (not related to you) with contact information.*
    Name:
    Phone:
    Email:
    Years acquainted?
    How do you know this person?
     
     
    Name:
    Phone:
    Email:
    Years acquainted?
    How do you know this person?
     
     
    Name:
    Phone:
    Email:
    Years acquainted?
    How do you know this person?
     
     

    PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

    I certify that all information provided in the employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I will be required to successfully pass a drug screening. I hereby consent to a pre-and/or post- employment drug screen as a condition of employment. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

    I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THIS ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE.

    I have read, understand, and by my signature consent to these statements.

    Signature
    Date

    WE ARE AN EQUAL OPPORTUNITY EMPLOYER