Merrilees Hardware & Supply Employment Application Form
Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
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11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
What store(s) are you interested in working at? (Select all that apply)
*
Cleves Location
Bright Location
Milan Location
Date Available to Work
*
How did you hear about this job?
Were you referred by a current employee?
Yes
No
Please give the name of the employee
First Name
Last Name
Job Preferences
The position you are applying for
Schedule Preferences
*
Full Time
Part Time
Seasonal
Other
Preferred Number of Hours per Week
*
Hours
Please indicate the times you are available to work (Please note that every employee is required to work every other weekend)
*
Rows
Open
Mid
Close
Other
Monday (7a-6p)
Tuesday
(7a-6p)
Wednesday
(7a-6p)
Thursday
(7a-6p)
Friday
(7a-6p)
Saturday
(7:30a-4p)
Sunday
(9a-2p)
Education
High School
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
*
Yes
No
College
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
Yes
No
Other
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Did you graduate?
Yes
No
Special Courses (Please list any additional training you may have received, including military training, apprenticeship programs, vocational training, courses or seminars, etc.)
Work History
Please include your present and/or most recent employers
*
Professional Licenses/ Certifications
Professional Licenses / Cerifications
Rows
Licence / Certification
State
License Number
Date Expires
1
2
3
References
References
Rows
Name
Current Position & Company
Phone Number
1
2
3
Have you ever been convicted of a felony or misdemeanor offense?
*
Yes
No
If yes, please explain
Are you legally eligible for employment in the United States of America?
*
Yes
No
Declaration
I, the applicant undersigned, agree with the following statements:
*
I declare that all information provided in this form is true and complete.
I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered later.
IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME. I UNDERSTAND MY EMPLOYMENT IS TENTATIVE BASED UPON A SUCCESSFUL COMPLETION OF A 10 YEAR CRIMINAL BACKGROUND CHECK AND BADGING PROCESS FOR ALL POSITIONS REQUIRING ACCESS WITH THE AIRPORT.
I acknowledge that I meet all required qualifications for this position and am able to perform the job responsibilities outlined in the job posting.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Submit
Submit
Should be Empty: