Our Mission
Improving lives one sale at a time
Name:
*
First Name
Last Name
Phone Number:
*
E-mail Address:
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Location
*
Please Select
Haughton
Mansfield
Blanchard
Are you legally authorized to work in the United States?
*
Yes
No
All applicants will be tested for illegal drug use and a criminal background check will be obtained before hire.
*
I Understand
Have you ever been convicted of a felony?
*
Yes
No
If yes, please explain
Are you currently employed?
*
Yes
No
Position Applying For
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Please Select
Cashier
Marketing
Retail Sales Floor
Outside Sales
Warehouse
Book Keeping
CDL Driver Class A
Class D Driver
Type
*
Part/Time
Full Time
Days Available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Employer
Start Date
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Month
-
Day
Year
Date
End Date
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Month
-
Day
Year
Date
Phone
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position
Salary/Hourly pay
Supervisor/Manager
Reason For Leaving
Employer
Start Date
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Month
-
Day
Year
Date
End Date
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Month
-
Day
Year
Date
Phone
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position
Salary/Hourly pay
Supervisor/Manager
Reason For Leaving
References
Please list two (2) references that are familiar with your work life.
Reference 1
Name:
*
First Name
Last Name
Phone Number
*
Years Known:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reference 2
Name:
*
First Name
Last Name
Phone Number
*
Years Known:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Training , Certifications or Skills You Would Like to Mention:
I certify that the statements made in this application are true and correct to the best of my knowledge and belief. I affirm that I have a genuine intent and no other purpose in applying for a job with this company. I understand that misrepresentation or omission of facts called for in this application may lead to rejection of the application or separation from the company’s service if I have been employed. I authorize investigation of all statements contained in this application and verify my consent to be physically examined if necessary.
*
I understand
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