JLM Employment Application - Repeat Boutique (2024)

Repeat Boutique Employment Application

Applicant Information

Open Position (Please select the position for this application): Select ... Part-Time Sales Associate

Full Name (Last, First, M.I.)

Street Address:

City, State and Zip Code:

Phone:

Email:

Date Available:

Social Security Number:

Desired Salary:

$

Are you a legal citizen of the United States? Select ... Yes No

If no, are you authorized to work in the United States? Select ... Yes No

Have you ever worked for this company? Select ... Yes No

If you have worked for this company, please state when:

Have you ever been convicted of a felony? Select ... Yes No

If yes, please explain:

Education

High School & Address:

From Date / To Date (High School):

Did you graduate (High School)? Select ... Yes No

Did you receive your Diploma (High School)? Select ... Yes No

College & Address:

From Date / To Date (College):

Did you graduate (College)? Select ... Yes No

Type of Degree Received (College):

Other Education & Address:

From Date / To Date (Other Education):

Did you graduate (Other Education)? Select ... Yes No

Type of Degree Received (Other Education):

References

Please list three professional references.

Full Name / Relationship (Reference 1):

Company & Address (Reference 1):

Phone (Reference 1):

Full Name / Relationship (Reference 2):

Company & Address (Reference 2):

Phone (Reference 2):

Full Name / Relationship (Reference 3):

Company & Address (Reference 3):

Phone (Reference 3):

Previous Employment

Company & Address (Prev Empl 1):

Job Title & Supervisor Name (Prev Empl 1):

Supervisor Contact Number (Prev Empl 1):

From Date / To Date (Prev Empl 1):

Starting Salary (Prev Empl 1):

$

Ending Salary (Prev Empl 1):

$

Summary of Responsibilities (Prev Empl 1):

Reason for Leaving (Prev Empl 1): Select ... Terminated Laid Off Quit

May we contact your previous supervisor for a reference (Prev Empl 1)? Select ... Yes No

Company & Address (Prev Empl 2):

Job Title & Supervisor Name (Prev Empl 2):

Supervisor Contact Number (Prev Empl 2):

From Date / To Date (Prev Empl 2):

Starting Salary (Prev Empl 2):

$

Ending Salary (Prev Empl 2):

$

Summary of Responsibilities (Prev Empl 2):

Reason for Leaving (Prev Empl 2): Select ... Terminated Laid Off Quit

May we contact your previous supervisor for a reference (Prev Empl 2)? Select ... Yes No

Company & Address (Prev Empl 3):

Job Title & Supervisor Name (Prev Empl 3):

Supervisor Contact Number (Prev Empl 3):

From Date / To Date (Prev Empl 3):

Starting Salary (Prev Empl 3):

$

Ending Salary (Prev Empl 3):

$

Summary of Responsibilities (Prev Empl 3):

Reason for Leaving (Prev Empl 3): Select ... Terminated Laid Off Quit

May we contact your previous supervisor for a reference (Prev Empl 3)? Select ... Yes No

Military Service

Military Branch:

From Date / To Date (Military):

Military Rank at Discharge:

Type of Military Discharge:

If other than honorable military discharge, please explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false and misleading information in my application or interview may result in my release.

Signature:

Date:

You are not currently logged in. Please log in to submit this form.

Cancel