Employment Form
Please read this before completing the contact sheet! In reading and answering the following questions, please keep in mind that none of the questions are intended to imply any limitations, preferences, or discrimination based on any non-job-related information.

By completing the form, there is no assurance of employment. Use of this form does not indicate there are positions available. Data entered here will be added to an employment application which you can complete at the store.

Personal Information:

First Name:
Middle:
Last Name:
Phone:
Email:
  
Address:
Floor/Suite:
City:
State/Zip:
 
   Position & Availability:

Store Location. Please indicate the location where you would like to apply.

Postion(s) Desired. Please indicate the positions that you would like to apply for (i.e. cashier).

Date available for work:

Hours available for work: Please list specific hours for each day.
 Mon.   Tues.   Wed.   Thurs.   Fri.   Sat.   Sun. 
Age: I am under 16 years of age I am 18, or older.

Briefly state why you would like to work with our company:


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