Employment Application

H&R Block, its subsidiaries, and its franchisees (US franchisees) are equal opportunity employers and consider all persons for employment regardless of race, color, national origin, age, disability, veteran status, religion, gender, sexual orientation, marital status, or status in any group protected by federal, state or local law. No question, on this application, is intended to secure information to be used for discriminatory purposes. This application will be considered only for the positions indicated below, providing the positions are open at the time of application submission. Receipt of this application does not imply that the applicant will be employed. H&R Block, its subsidiaries and its franchisees hire only United States citizens and aliens lawfully authorized to work in the United States. All new associates will be required to certify that they are eligible for employment in the United States.

Full Name

First NameMiddle NameLast NameSuffix

Address

Street Address

Street Address Line 2

CityState

Zip Code

Mobile Phone Number

Format: (000) 000-0000.

Personal E-mail Address

Are you under the age of 16?

Are You a U.S. Citizen?

If you are not an U.S. citizen, are you currently legally authorized to work in the United States?

Enter Your Social Security Number

Enter Your Date of Birth

Date

Position(s) Applying For

Have You Worked for H&R Block, Its Subsidiaries or Its franchisees Before?

If you have, please provide your H&R Block Employee ID (if applicable)

High School

Name of High School Attended

Number of Years Attended

Graduated?

College

Name of College/University Attended

Number of Years Attended

Graduated?

Area of Study/Degree

Graduate School

Name of Graduate School Attended

Number of Years Attended

Graduated?

Area of Study/Degree

Trade School/Other

Name of Trade/Technical/Other School Attended

Number of Years Attended

Graduated?

Area of Study/Degree

List any other education, experiences, qualifications, licenses, certifications, or skills related to the position(s) for which you have applied (if not already listed) e.g. Tax Courses, Securities, or Insurance training.

Do you speak another language?

If yes, please list the language(s) below and include your level of proficiency for each

Current Employer

Name of Current Employer or NONE if not Employed

Position

Salary

Reason for Leaving?

Start Date

MonthDayYear

Manager or Direct Report

First NameLast Name

May We Contact?

Phone Number of Manager or Direct Report

Format: (000) 000-0000.

Previous Employer

Name of Previous Employer

Position

Salary

Reason for Leaving?

Start Date

MonthDayYear

End Date

MonthDayYear

Manager or Direct Report

First NameLast Name

May We Contact?

Phone Number of Manager or Direct Report

Format: (000) 000-0000.

Previous Employer

Name of Previous Employer

Position

Salary

Reason for Leaving?

Start Date

MonthDayYear

End Date

MonthDayYear

Manager or Direct Report

First NameLast Name

May We Contact?

Phone Number of Manager or Direct Report

Format: (000) 000-0000.

Date You Can Start

MonthDayYear

On Average, How Many Hours Will You Be Able To Work During Tax Season (Jan 2- April 15)?

Please indicate the days and times you are available to be scheduled to work during tax season (Jan 2 - April 15):

Rows	My Availability Starts At	My Availability Ends At	I am available to work anytime on this day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Additional Information Regarding Your Availability

Hawaii Applicants: Do not answer the criminal history section. Any offer of employment is contingent on completing a post offer questionnaire regarding your criminal history. Please read the instructions carefully before answering questions regarding criminal history. For these instructions, the words ''convicted'' and ''conviction'' include guilty pleas and pleas of ''nolo contendre'' or ''no contest.'' If you question whether your conviction is excluded, consult your own attorney. You are responsible for accurately responding to questions about your criminal history. This instruction applies to both adult and juvenile records and to both felony and misdemeanor convictions. You may answer as if you have no record if the record has been sealed, expunged, or statutorily eradicated. This includes convictions that are judicially dismissed or discharged prior to a final adjudication of guilt. . Your arrest resulted in a diversion program, provided that you satisfied all of the requirements of the diversion program. . Your conviction was pardoned.

Juvenile Convictions: You are not required to disclose juvenile records.

Misdemeanor Convictions: You are not required to disclose misdemeanor convictions except for those crimes involving dishonesty or theft (e.g., fraud, forgery, check kiting, shoplifting, larceny, embezzlement). If you are applying for a position that will require driving, you must also disclose any conviction for driving under the influence.

Time Limits: You are not required to disclose any felony conviction that is more than 10 years old. You are not required to disclose any misdemeanor conviction that is more than five years old unless you have been convicted of another offense during the last five years. If you have been convicted of another offense within the last five years, you must disclose all convictions that occurred within the last 10 years other than those excluded in the above instructions. For purposes of this instruction, if you were incarcerated as a result of your conviction, use the last date of incarceration rather than the date of conviction in calculating the five year or 10 year period.

Have you ever, under your name or another name, been convicted of (or pleaded guilty or nolo contendere to) a felony? (Securities laws and regulations dictate that certain convictions may be an automatic bar to employment. For all other positions, conviction does not automatically bar employment, but will be considered as it relates to fitness to perform the job).

If yes, state facts including dates of conviction:

Have you ever, under your name or another name, been convicted of (or pleaded guilty or nolo contendere to) a misdemeanor? (Securities laws and regulations dictate that certain convictions may be an automatic bar to employment. For all other positions, conviction does not automatically bar employment, but will be considered as it relates to fitness to perform the job).

If yes, state facts including dates of conviction:

Have you ever, under your name or another name, been convicted of (or pleaded guilty or nolo contendere to) a violation of any State or Federal Tax Laws? (Conviction does not automatically bar employment, but will be considered as it relates to fitness to perform the job).

If yes, state facts including dates of conviction:

Are you currently on probation or parole?

If yes. state facts including dates:

Some positions require acceptance in the Internal Revenue Service electronic filing program as a condition of employment. Suspension from or denial of participation in the program may automatically bar employment based upon Internal Revenue Service electronic filing program guidelines. All circumstances will be considered as they relate to the position for which you are applying. Are you currently under suspension from the Internal Revenue Service electronic filing program?

If yes, state Facts:

Have you ever held, or do you currently hold an Electronic Filing Identification Number from the Internal Revenue Service? (An Electronic Filing Identification Number or EFIN is a 6-digit tax identification number issued by the IRS to businesses that have been approved as Authorized IRS e-File providers. The EFIN is used to identify the location from where an e-filed return was sent).

If yes, state Facts:

Have you ever been denied acceptance into the Internal Revenue Service electronic filing program?

If yes, state Facts:

Cover Letter

Upload a File

Resume

Upload a File

By signing above and clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. Furthermore, I agree that my digital signature on this form/document is as valid as if I signed the document in writing. I hereby authorize H&R Block, any of its subsidiaries or franchisees to investigate my qualifications with previous employers and other sources as necessary, except those whom I have indicated to exclude. I understand that my employment is contingent upon my ability to certify and to show that I am eligible for employment in the United States. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.

Signature

Employment Application Form:

Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Current Employment:

Previous Employment:

Availability:

Criminal History Disclosure Instructions:

Please ensure that you have read the above Criminal History Disclosure instructions prior to completing the following questions.

Cover Letter & Resume (Optional):

Send Application: