Employment Application

Prospective employees will receive consideration without discrimination because of race, creed, sex, age, sexual orientation, national origin, handicap or veteran status.

Last Name , First Name MI
Street Address
City , State Zip

Phone
Email Address
Position Desired
Salary Desired

List days and hours you are available

Are you legally eligible for employment in the United States? YesNo

What qualities or characteristics do you possess that make you qualified for this position?

Education

School Name & Location Course of Study Num of Years Completed Did you Graduate Degreee or Diploma
Graduate
College
Business
High School

Retail and Other Relevant Experience (Please indicate retail and volunteer experience relevant to this position)

Employment and Military Service
List below your last three employers, starting with your present or most recent employer. Please give accurate, complete full-time, part-time and military employment information.

Company Name and Phone Number
Employment Date – State Month and Year: From To
Address
Rate of Pay
Name of Supervisor or Other Work Reference
Position
Reason For Leaving
State Job Title and Describe Your Work Duties

Company Name and Phone Number
Employment Date – State Month and Year: From To
Address
Rate of Pay
Name of Supervisor or Other Work Reference
Position
Reason For Leaving
State Job Title and Describe Your Work Duties

Company Name and Phone Number
Employment Date – State Month and Year: From To
Address
Rate of Pay
Name of Supervisor or Other Work Reference
Position
Reason For Leaving
State Job Title and Describe Your Work Duties

We may contact the employers listed above unless you indicate those you do not want us to contact.
Do Not Contact - Name: Reason

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this Application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.