Employment Application

EMPLOYMENT APPLICATION

Miskelly Companies provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. No questions on this application are intended to secure information to be used in such discrimination. The use of this form does not mean positions are open, at does not obligate the company, in any way.

Full Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

Area CodePhone Number

Secondary Phone Number

Area CodePhone Number

E-mail*

Confirmation Emailexample@example.com

Referral source

Ex: Advertisement, Social Media, Employee, Customer, Other

Referred by

Desired Position(s)*

Ex: Sales Associate, Retail Operations, Distribution, Delivery, Corporate

Desired Work Schedule

Are you available to work?*

Full timePart timeTemporarySeasonal

On what date would you be available for work?*

Date

Wage expectations*

Ex: $30,000, $15/hr.

Have you applied here before?*

YESNO

Have you ever been employed here before?*

YESNO

Are you currently employed?*

YESNO

May we contact your current employer?*

YESNO

Are you legally authorized to work in the United States on a full-time basis?*

YESNO

Have you been convicted of a crime (other than minor traffic offense) or pled no contest to a crime? (Answering "Yes" to this question will not necessarily disqualify you from the position desired. Any conviction and the circumstances will be evaluated in relation to the position for which you are applying.*

YESNO

Miskelly Furniture Applicant Background Check Authorization*

	Date	Offense	Place of Conviction	Length of Sentence/Amount of Fine
1
2
3

Explain

EDUCATION

Highest level of education completed:*

Please complete the appropriate sections*

	Name & Location of School	Last Year Attended	Did You Graduate?	Diploma/Degree	List any licenses, certifications, specialized training, skills, apprenticeships, or extracurricular activities	List any honors received
GED / High School
College
Graduate School
Other

EMPLOYMENT HISTORY

Start with your present or last job, including any military service or part-time employment. A resume may be included, but the information below must be completed as well.

1. EMPLOYER

Employer (Most current)

Address & location of business

Job title

Supervisor

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Wages FINAL:

Work performed:

Reason for leaving*

Were you ever disciplined, counseled, asked to resign or discharged because of job performance or violation of company rules at this organization? If yes please explain.

YESNO

Explain

2. EMPLOYER

Employer (Second most recent)

Address & location of business

Job title

Supervisor

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Wages FINAL:

Work performed:

Reason for leaving*

Were you ever disciplined, counseled, asked to resign or discharged because of job performance or violation of company rules at this organization? If yes please explain.

YESNO

Explain

3. EMPLOYER

Employer (Third most recent)

Address & location of business

Job title

Supervisor

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Wages FINAL:

Work performed:

Reason for leaving*

Were you ever disciplined, counseled, asked to resign, or discharged because of job performance or violation of company rules at this organization? If yes, please explain.

YESNO

Explain

Please let us know of any skills, certifications, software, affiliations, or personal characteristics you would like us to consider in reference to an employment opportunity at Miskelly Furniture.

REFERENCES: Please give the name, phone number, relationship and years known of three references who are not related to you.*

	Name	Phone Number	Relationship	Years Known
1.
2.
3.

First Name Last Name Area Code Phone Number Relationship Years Known

APPLICANT STATEMENT:

I understand further that any misstatements/falsifications or omissions in this application will result in a decision not to hire me or to discharge me if discovered only after hire. I understand that any other offer of employment by Miskelly Furniture will be conditioned upon successful completion of a post offer, pre-employment drug test, criminal conviction history and driving history. I hearby give my consent to any such examination(s). I agree to conform to the rules and regulations of Miskelly Furniture. I understand that my employment is at-will and can be terminated with or without cause and with or without notice, at any time, at the option of either Miskelly Furniture or myself.

This application for employment shall be considered active and on file for 90 days. An applicant wishing to be considered for employment after this time period should reapply by completeing a new application.

You must agree to accept the terms of the document in order to submit an application.

By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree

Type signature*

Date*

Date

Upload your resume, click Choose File

Upload a File

Upload a cover letter, click Choose File

Upload a File

AUTHORIZATION FOR BACKGROUND INQUIRY

I authorize Miskelly Furniture to conduct a background investigation on
myself including, but not limited to, prior
employment and earnings history.

I understand this may include information as to my character, work habits, job performance, and experience, along with reasons for termination of past employment.

I understand that any information obtained may be used to evaluate my qualifications for the position for which I am applying.

I authorize, without reservation, any person or agency to furnish the above information to:

Miskelly Furniture

Human Resources Department

Airport Road

Pearl, MS 39208

I authorize that a photocopy or fax of my signature below may be used to obtain information. I further understand that to aid in the proper identification of my file or records I am providing the following information:

By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree

Any prior names, maiden name, nickname, or aliases: First Name Last Name

Date*

Date