"We are an equal opportunity employer."

This application will be kept on file for 6 months from date of application (for store to fill):

Mgr­­­­­­­­­ _________________________________________

Date ________________________

(NOTE: If you feel that your civil rights would be violated by answering a question on this form, please omit the answer to that question with a hypen (-).)

Please insert times on each day you would be available to work below.

U.S. ARMED FORCES HISTORY

GENERAL INFORMATION

EDUCATION

EMPLOYMENT EXPERIENCE / WORK HISTORY


Omit Military Service History – Give Present or Most Recent Position First

Information must be complete and accurate.

Start with your present or last employer. If you need more space, use an extra sheet of paper. If summer or part-time work, please indicate. If you were employed under a maiden or other name, please indicate that name by the employer.

We are an equal employment opportunity company. We are dedicated to a policy of non-discrimination in employment on any basis, including race, creed, age, sex, religion, national origin, height, weight, marital status, or disability.

I certify that the information contained in this application is correct to the best of my knowledge and understand that deliberate falsification of this information is grounds for dismissal in accordance with this company’s policy. I authorize the references listed above to give you lawful information concerning my previous employment. I agree to undergo a character investigation and I agree to take an honest verification test in accordance with State and Federal laws upon reasonable suspicion of any and all discrepancies involving my work. I understand that no representative of the company except the President has the authority to enter into my agreement for employment for any specified period of time, nor am I obligated to work for the company for any specified period of time. The President’s agreement must be in writing.