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Columbus Ace Hardware Job Application

* = Required Fields

Jelinek Hardware Company is an equal opportunities employer and fully subscribes to the principles of Equal Employment Opportunity. Equal access to programs, services and employment is available to all persons. Applicants requiring accommodation to the application and/or interview process should contact a representative of the Personnel Department. Applications will be considered active for 90 days.

* What type of work are you interested in? Management Sales Maintenance/Warehouse
Small Engine Technician Cashier Office/Clerical

Other, please specify

Full Time
Part Time
Seasonal

Personal

* Last Name * First Name * Middle Name

* Street Address * City * State * Zip Code

* Phone Number * Email Address

Previous Address City State Zip Code

Reason for moving from previous address

* Best time to reach you at home
May we contact you at work? If Yes, Work Number Best time to reach you at work

Referral Source Advertisement Walk In Employee Online Other

* Have you been convicted of a felony in the last seven (7) years? (Such conviction may be relevant if job related, but does not bar you from employment.)

If yes, please explain

* Driver’s license number * State

 
Education
* Highest year of High School completed * Graduated GED
College or Tech School Graduated Graduate School
High School City State
College/Technical City State
List any additional education
Are you attending school now? If yes, list days and times you attend school

 

Employment History - List current and previous employers below. Begin with the most recent employer.

#1 Current or Past Employer
Street Address City State Zip Code
Supervisor Work Number May we contact this employer?
Date Started Year Leaving Date Year Status
Starting Pay Rate Final Pay Rate
Describe Job Duties
Reason you left
Length of time of inactivity between this application date and Employer #1 years months
Reason for inactivity between this application date and Employer #1
#2 Current or Past Employer
Street Address City State Zip Code
Supervisor Work Number May we contact this employer?
Date Started Year Leaving Date Year Status
Starting Pay Rate Final Pay Rate
Describe Job Duties
Reason you left
Length of time of inactivity between Employer #1 and Employer #2 years months
Reason for inactivity between Employer #1 and Employer #2
#3 Current or Past Employer
Street Address City State Zip Code
Supervisor Work Number May we contact this employer?
Date Started Year Leaving Date Year Status
Starting Pay Rate Final Pay Rate
Describe Job Duties
Reason you left
Length of time of inactivity between Employer #2 and Employer #3 years months
Reason for inactivity between Employer #2 and Employer #3

 
What hourly wage or salary do you expect? per hour per week
* List the times you will be available to work during our store hours: Sunday 9 am to 6 pm, and Monday through Saturday 7:30 am to 9 pm
Sunday to
Monday to
Tuesday to
Wednesday to
Thursday to
Friday to
Saturday to

 

Skills and Qualifications

Summarize any specific work skills you have which may not be adequately covered in review of your work or educational
history. (Include special training, licenses, certificates and/or characteristics of yourself that may apply).


 

References

List name and telephone number of three personal references who are not related to you and are not previous supervisors.
* Name
* Phone Number
* Years Known

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer’s service if I have been employed.
I give the employer the right to investigate all references and to secure additional information about me, if job-related.
I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.
The employer is an Equal Opportunity Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicantʼs consideration for employment on a basis prohibited by local, state or federal law.
I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the employer has the authority to make any assurances to the contrary.
I understand it is this companyʼs policy not to refuse to hire a qualified individual with a disability because of this personʼs need for an accommodation that would be required by the ADA.This application is current for only 90 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.