Join the Team v3.0

Success Vision Express Employment Application
Name*

PrefixFirst NameMiddle NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Email*
example@example.com
Are you currently employed?*

YesNo
Which location would you prefer to work at?*
Other - Please describe:*
Position Desired (general)*
Other - Please describe:*
Position Desired*
Other - Please describe:*
Position Desired*
Other - Please describe:*
Position Desired*
Other - Please describe:*
Position Desired*
Other - Please describe:*
Position Desired*
Other - Please describe:*
Position Desired*
As a licensed optician you will be:

Following the rules and regulations for licensed opticians for your state; Working with apprentice opticians to aid in their career growth; and offering professional recommendations regarding frame and lens options to the customers at Success Vision Express.
As a lab technician you will be:

Training and working in our full service lab. You will learn how to manufacturer lenses and how to prepare them for dispensing to the customers at Success Vision Express.
As an optical sales associate you will be:

Training and working with Licensed Opticians you will learn how to properly present frame and lens options as well as make frame adjustments and dispense eyewear.
As a paraoptometric technician, you will be:

Answering phones, scheduling appointments, pre-testing patients, rooming patients, conducting contact lens fittings, VEP, pERG testing, and dilation for patients.

NOTE: This position is only available at our Cape Girardeau, MO, Manhattan, KS and Paducah, KY locations.
As a home office employee you will working in any number of departments, including:

Accounting, Insurance, Marketing, Warehouse, Human Resources, Maintenance, Grounds Keeping and IT.
Job responsibilities:

Collect, prepare, analyze and summarize findings from data pulled internally (database) and externally (field research), on customer behavior, trends, and other aspects of our business, for quick understanding and analysis by executives and managers.
Hourly wage desired*
Click here to take a one minute typing test: One minute typing test
Typing speed, in words per minute*
When are you able to start work at Success Vision Express?*

MonthDayYear
Do you have reliable transportation?*

YesNo
How many hours per week would you prefer to work?*
Which days and hours are you available to work during the week?*
i.e. Monday-Thursday 9-5, Tuesday-Friday 8-12, etc.
Are you able to attend staff meetings every Tuesday from 7pm to 9pm?*

YesNo
Are you available to work most Saturdays?*

YesNo
Are you willing to take a drug test?*

YesNo
Have you ever been convicted of a misdemeanor or felony?*

YesNo
What made you apply for Success Vision Express?*
Have you previously applied to Success Vision Express?*

YesNo
(Required): Please upload a 1 to 3 minute video telling us why you want to work for Success Vision Express, as well as an achievement you are proud of.*

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How did you hear about Success Vision Express?*
Friend or Employee Name:

First NameLast Name
Other:
Which high school did you attend?*
How many years of high school did you attend?*
Did you graduate?*

YesNo
What was your high school GPA?*
College
What year did you graduate from college?
What was your college GPA?
Have you ever served in the armed forces?*

YesNo
Which service branch?
How many years did you serve in the armed forces?
Were you honorably discharged?

YesNo
If you received an other than honorable discharge, please list why.
Previous employment
Employer name*
Enter "None", if this is your first job, or "Current", if currently employed here.
Hourly or salaried rate of pay*
Enter "None" if this is your first job.
Start date*

MonthDayYear
End date

MonthDayYear
Employer name*
Enter "None", if this is your first job, or "Current", if currently employed here.
Hourly or salaried rate of pay*
Enter "None" if this is your first job.
Start date*

MonthDayYear
End date

MonthDayYear
Employer name*
Enter "None", if this is your first job, or "Current", if currently employed here.
Hourly or salaried rate of pay*
Enter "None" if this is your first job.
Start date*

MonthDayYear
End date

MonthDayYear
Personal references

Please list 2 personal references, not related to you.
Reference Name*
Relationship*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Reference Name*
Relationship*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Please list any special training, experiences or skills that may be relevant for the position:
Please list any volunteer service projects, high school/college clubs, overseas missions or non-profit organizations that you have been involved with:
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
Today's date*

MonthDayYear
Signature (please type your full name)*
Attach Résumé

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Success Vision Express does not discriminate in employment on the basis of race, color, religion, sex, national origin, disability, age, military service, or other non-merit factor.
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