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  • Store Associate positions available – Full time /Part time

    Must be 21 and over and have great customer service skills.

Employment Application

Applicants are considered for all positions without regard to race color, religion, sex, national origin, sexual orientation, veteran's status, age, disability or the presence of a non-job related medical condition or handicap.
* Notes a required field.

Personal Data:
Address:

Employment Data:
Full Time Part Time Seasonal Help
Manager Asst. Manager Cashier Stocker
Hourly Wage:
Monthly Wage:
Start Date:

Fill in the blank under each day of the week with the hours you can not work.
MondayTuesdayWednesdayThursdayFridaySatrudaySunday

No: State: Type:
Currently Valid: Yes No
Yes No

A yes answer will not necessarily disqualify you from employment. The date and nature
of the offense will be considered in light of the nature of position for which you are applying.		 Yes No
Are you 21 years of age or older? Yes No
Have you ever applied to our company before? * Yes No
Have you ever been employed with our company? * Yes No
If yes, when and where?
Are you currently employed? * Yes No
If yes, may we contect your present employer? Yes No
Do you have any relatives currently working for this company? *
If yes, list the following information. 		Yes No
Name: Relationship: Work Loc:

Former Employers (List your last three employeers, starting with your current or most recent)
Most recent employer
From
To

2nd most recent employer
From
To

3rd most recent employer
From
To

References: Give two references, not including relatives or former employers.
Name *
Phone *
Name *
Phone *

Education
High School
Name
City
State
Years completed 9 10 11 12 GED

Trade School or Education other than College
Name
City
State
Years completed

College
Name
City
State
Years completed 1 2 3 4

Emergency Contact
Name
Address
Phone

I certify that the foregoing statements are true and correct to the best of my knowledge and belief and hereby grant the Company permission to verify such answers. I understand that any false statements on the application or at any time during the selection process including interviews, tests, etc., may be considered as sufficient cause for rejection of my application or for dismissal if such false statement is discovered subsequent to my employment. I hereby authorize the Company to conduct an investigative consumer report on me, as defined in Public La 91-508 and/or the Fair Credit Reporting Act, and I understand that such a report may include information as to my character, general reputation, personal characteristics, criminal history, financial condition and mode of living. I understand that, if any inquiry is made, the nature and scope of information will be supplied to me upon written request. If I am employed, I agree to abide by and comply with all the rules of the Company. I further understand and agree that, if I am employed , my employment is for no definite period and may be terminated at any time by either me or the Company. Additionally, I understand that this application will be considered in reference to the position(s) for which I applied at the time to completion of this form and that it will remain active for two weeks from receipt. *