Intimate Treasures Application

Application for Employment

Instructions: Please enter your information. Answer all questions.

An Equal Opportunity Employer. All applicants will be treated fairly in conformity with all existing federal and state laws. In answering the questions below, if you have any doubt as to the propriety or legality, ask the Personnel Office for an explanation of the questions.

Location of Store Applying For

Name

Please include prefix, first, last, and suffix.

Street Address

City

State

Zip Code

Home Phone

Please include area code, and remove all dashes or symbols.

Cell Phone

Please include area code, and remove all dashes or symbols.

Work Phone

Please include area code, and remove all dashes or symbols.

Email

Are you at least 18 years of age?

Yes No

Are you eligible to work in the United States?

Yes No

Have you been convicted of any crime other than a minor traffic offense within the last five years?

Yes No

If yes, answer in the space below to the nature of crime, when, where, and disposition of case.

(conviction of a crime is not an automatic bar to employment)

Position Applying For:

Salary/Wage Expected

Days Available

Hours Available

AM PM

For specific Day/Hour availability, please enter information below.

What date are you available to start work?

How were you referred to this organization?

Do you have any friends or relatives in our employ?

Yes No

If yes, give full name and relationship to this person.

Have you ever worked for this organization before?

Yes No

If yes, when?

What position?

This application is current only for thirty (30) days, at the conclusion of which time, if you have not heard from us and still wish to be considered for employment, it will be necessary for you to fill out a new application.

These next few fields require multiple pieces of information each. Do NOT leave out any information that is requested.

Education

Please enter the name and address, as well as your degree/diploma and your graduation date.

Military Service

Please enter the branch, dates active, rank, description of duties, and any skills or qualifications(Licenses, Skills, Training, Awards).

Employment History

Please include the following information: employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary (or hourly wage), and reason for leaving.

Employment History

Please enter the employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary(or hourly wage), and reason for leaving.

Do this for each previous employment that you wish to disclose.

Employment History

Please include the following information: employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary (or hourly wage), and reason for leaving.

Employment History

Please enter the employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary(or hourly wage), and reason for leaving.

Do this for each previous employment that you wish to disclose.

Employment History

Please include the following information: employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary (or hourly wage), and reason for leaving.

Employment History

Please enter the employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary(or hourly wage), and reason for leaving.

Do this for each previous employment that you wish to disclose.

Employment History

Please include the following information: employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary (or hourly wage), and reason for leaving.

Employment History

Please enter the employer, address, supervisor, phone number, email, position, start and end date, responsibilities, salary(or hourly wage), and reason for leaving.

Do this for each previous employment that you wish to disclose.

Health Information

Yes No

Do you have any physical or mental impairments that would interfere with your ability to do moderate to heavy lifting, moderate climbing, operate equipment, or move around the store on a frequent basis?

If Yes, Please Explain

DRUGS IN THE WORK PLACE

We reserve the right to ask applicant to submit to a drug test before employment and/or a random drug test anytime during the duration of your employment.

In case of emergency, notify:

Include full name and phone number as well as an alternate number this person can be reached.

CERTIFICATION

I certify that information contained in this application is correct to the best of my knowledge and understand that falsification or misrepresentation is grounds for dismissal in accordance with the COMPANY policy.

I authorize the references listed in this application to give you any and all information that they may have, and release all parties from all liability for any damage that may result from furnishing same to to you.

In consideration of my employment, I agree to confirm to the rules and regulations of the Company and my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Company or myself and without notice or liability for wages or salary except such earned at the date of such termination. I understand that no manager, supervisor or representative of management, specified period of time, or to make any agreement contrary to the foregoing.

Do you agree with these terms and conditions?

Yes, I agree.

Initial

Date