Date Called: EMPLOYMENT APPLICATION Interview Date: NOTICE We Consider applicants without regard to race, color, religion, sex, national origin, age, marital or veteran status, handicap or any other legally protected status. Those requiring reasonable accommodation during the pre-employment process are required to notify our Human Resources Department. We hire only applicants that are legally authorized to work in the United States. We require all new employees to provide necessary identification for completion of Form I-9 to satisfy federal immigration laws. PERSONAL INFORMATION Please print Last Name First Middle Street Address (no P.O. Boxes) Please print Date Home Phone City State Previous Address City State Zip Other Phone Zip What is the Best time to Contact you? Type of employment desired: COMPLETE ONLY if under 18 years old Full Time Part Time Temporary Seasonal Other Please list your Birthday List days and times you are available for work: Mon Tue Wed Thu Fri Sat _____/_____/_____ Sun Have you ever applied for employment with us before? Yes No If yes when? Have you ever been employed by one of our companies before? Wage expected Yes No If yes, list location and date: Please list all relatives currently employed by one of our companies If hired, when would you be available for work? Are you legally eligible for employment in the U.S.A.? Have you been convicted of a crime, excluding conviction for a misdemeanor? Yes No If yes, give date(s) and details: List other special training or skills that have a direct bearing on the position that you are seeking OTHER INFORMATION Please list the position(s) you are seeking: Please list the location you would like to work at: Is there anything else about yourself that you would like to share with us? Please print EMPLOYMENT HISTORY Please print Please list all employment, assignments or volunteer positions, current and previous, full or part time including military experience. Start with your present or most recent employer. Give an accurate and complete record. Employer Telephone Complete address Employment dates Start End Wage History Start End City/State/Zip Supervisor Reason for leaving List job title and duties Employer Telephone Complete address Employment dates Start End Wage History Start End City/State/Zip Supervisor Reason for leaving List job title and duties Employer Telephone Complete address Employment dates Start End Wage History Start End City/State/Zip Supervisor Reason for leaving List job title and duties Employer Telephone Complete address Employment dates Start End Wage History Start End City/State/Zip Supervisor Reason for leaving List job title and duties May we contact your current employer? Yes No Have you been known by any other name? Yes No If yes, list name Please print School or Training EDUCATION – TRAINING Name and Location of School Course of Study Number of Years Completed? Please print Did you Graduate? Degree or Diploma? High School College Other Business, Trade, Etc. PERSONAL REFERENCES Please DO NOT list relatives Name Address Phone Number Years Known PLEASE READ CAREFULLY BEFORE SIGNING I certify that the facts set forth in my application for employment are true, accurate and complete. I understand that any false statement or information on this application could cause my application to be disqualified. If any false information is discovered after employment, it will be grounds for dismissal by the employer. I further understand that this application does not obligate the potential employer in any way, nor does it constitute a contract for employment. If employed, I understand and agree that employment would be “at-will” and can be terminated by either party with or without cause, at any time. I understand that no one person of this company has the authority, regardless of position, to enter into any agreement for employment, expressed, implied, written or verbal, for any specified period of time. I also understand that this application will remain active for a period of six months and I may be required to submit another application after that time. I authorize the potential employer to contact, verify or obtain information from all my references, employers and educational sources contained in this application. I hereby release the potential employer and it’s representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENTS COMPLETELY! My signature below certifies that I have read, understand and accept all information on this application. Signature of Applicant Date AREAS OF INTEREST Please indicate the areas where you have experience, training or interest. Place a check in all boxes that apply. List specific interest within an area that you would like to work in. Area of Store Specific interest within an area Archery Guns Athletics Footwear Fishing Camping Clothing Cashier Service Desk Inventory Processing Transportation Maintenance Office/Clerical Buying Management Other This area is intended for the interviewer’s notes. No Experience Basic Knowledge # Years of Experience