Application for Employment Please enable JavaScript in your browser to complete this form.Position You Are Applying For: *Cashier/StockerSales AssociateDesired Hourly RateDate Available for Work: *Name *FirstLastAddress *City *State *Zip *Email *Contact Number *Emergency Contact Name & Relation *Emergency Contact Number *Are you a U.S Citizen? *YesNoSocial Security Number *Have you ever been convicted of a felony? *YesNoIf selected for employment, are you willing to submit to a pre-employment drug screening test? *YesNoEDUCATIONPlease list School Name, Location, Years Attended, Degree Received (if applicable).Previous Employer & Address: *Previous Supervisor's Name & Number: *Previous Position Held & Dates Employed: *Previous Pay Rate: *Duties Performed: *Previous Employer & Address: Previous Supervisor's Name & Number:Previous Position Held & Dates Employed: Previous Pay Rate:Duties Performed: Reference #1: *Please include Name, Phone Number, and RelationReference #2: *Please include Name, Phone Number, and RelationReference #3: *Please include Name, Phone Number, and RelationI certify that all answers given herein are true and complete to the best of my knowledge. *YesI authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. *YesIn the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. *YesBy typing my name, I certify that this is my authorized e-signatureDate *MessageSubmit