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Retail - Employment Application
Desired Location :
Applicant Information
Full Name:
Date:
Last First M.I.
Address:
Street Address
Ap
artment/Unit #
Cit
y
State ZIP Code
Phone:
( )
E-mail Address:
Date Available:

Position Applied For:
Desired Salary:
$ hr
Availability:
( What hours
can you work )
MON TUE WED THUR FRI SAT SUN
FROM
TO
Are you at least 18 years of age?
YES
NO
If no, you may be required to provide a work permit upon hire.
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the U.S.?
YES
NO
Have you ever worked for this company?
YES
NO
If yes, when?
Have you ever been convicted of a felony?
YES
NO
If yes, explain:
Education
High School:
Address:
Did you graduate?
YES
NO
Degree:
College:
Address:
Did you graduate?
YES
NO
Degree:
Other:
Address:
Did you graduate?
YES
NO
Degree:
References
Full Name:
Relationship:
Company:
Phone:
( )
Address:
Full Name:
Relationship:
Company:
Phone:
( )
Address:
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