EmailMe Form - Employment Application

Contact Information

Name *

First Last

Home Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Mobile Phone *

### - ### - ####

Have you ever been convicted of a felony? *

YES

NO

Are you a US Citizen? *

YES

NO

Currently Employed? *

YES

NO

Employement History:

List previous jobs and dates of employment.

Education History (Completed): *

High School/GED

Currently in High School

College

Currently in College

Areas of expertise and special skill: *

List any qualitfications you have for this position or anything that you'd like us to know that would make you the perfect candidate.

Available Start Date: *

MM / DD / YYYY

Desired Houly Wage: *

What days and hours are you available to work? Will you be needing any time off in the next 6 months?

Our current store hours are Monday-Friday 10am-5:30pm, Saturday 10am-4pm and Sunday 12pm-4pm - but we also have several late night shopping events throughout the year.