Full Name

First Name

Last Name

Address

Please include street, city, state & zip code

Telephone

Date of Application

YYYY

Position Applied For:

Have you filed an application here before?

Yes

Have you ever been employed here before

Yes

If yes to the above, please give dates

Is your spouse/relative employed at Sandy's?

Yes

Are you currently employed?

Yes

Work Experience--Employer #1

Please list current/prior employers. Start with your present or most recent job. Include all positions which you have held during the past 10 years. Please include: Employer, Telephone, Dates Employed, Position, Address, Supervisor, Hourly Rate/Salary, Reason For Leaving

Employer #2

Please include: Employer, Telephone, Dates Employed, Position, Address, Supervisor, Hourly Rate/Salary, Reason For Leaving

Employer #3

Please include: Employer, Telephone, Dates Employed, Position, Address, Supervisor, Hourly Rate/Salary, Reason For Leaving

May we contact your present employer?

Yes

Are you a citizen of the United States?

Yes

If no to the above question, are you legally entitled to work in the United States?

Yes

On what date would you be available for work?

Are you able to work

Full Time

Part Time

Temporary

What are your hourly/salary requirements?

References

Give name, address, telephone number and relationship of three professional references, who are not related to you.

Education

List Highest Education Achieved (school, degree)

List Honors/ Awards

Summarize special skills and qualifications acquired from employment or other experience which are relevant to the position(s) you are applying for

Have you ever been convicted of a felony?

Yes

If yes to above,

Please indicate the date of all convictions, the particular offenses for which you were convicted and the final disposition of each matter

Have you been convicted within the past five years of any misdemeanor?

(other than a first conviction for drunkenness, simple assault, speeding, minor traffic violations, affray or disturbance of the peace?)

Yes

If yes to above,

Please indicate the date of all convictions, the particular offenses for which you were convicted and the final disposition of each matter

Please enter name and date in the space below as a signature

I certify that answers given herein are true and complete to the best of my knowledge. I understand that this application is not and is not intended to be a contract of employment.