Last Name* First* Middle ARE YOU 18 YEARS OF AGE OR OLDER?*If hired, you may be required to provide proof of age. Yes No DATE AVAILABLE:* TODAY's DATE* MM slash DD slash YYYY ADDRESS:* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code IF YOU HAVE LIVED AT THE ABOVE ADDRESS LESS THAN 12 MONTHS, LIST PREVIOUS ADDRESS: Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code TELEPHONE:* CELL#EMAIL:* DO YOU HAVE YOUR OWN RELIABLE TRANSPORTATION?* Yes No DO YOU HAVE A VALID DRIVER'S LICENSE?* Yes No IF YES, DL#:* STATE:* POSITION APPLYING FOR:* DO YOU WISH TO WORK:* Full-Time Part-Time Temporary IF TEMPORARY, SPECIFY DATES AVAILABLE: PLEASE INDICATE HOURS YOU ARE AVAILABLE TO WORK EACH DAY:*Example: 7am - 6pmSundayMondayTuesdayWednesdayThursdayFridaySaturday YOUR EDUCATION HIGHEST EDUCATION ACHIEVED*Academic Institution/ LocationYears Completed CERTIFICATIONS/SKILLS Please provide applicable information below column titles:Commercial Drivers LicenseCDL ClassForkLift Certified: Yes or NoLIST LANGUAGES YOU SPEAK PROFICIENTLY:* List any experience, skills, hobbies or special abilities you consider pertinent to the job you are applying for: EMPLOYMENT HISTORY Give names and contact phone number of your last 3 employers.MAY WE CONTACT YOUR PRESENT EMPLOYER?:* YES NO Employer Name Employer Phone #Employed From MM slash DD slash YYYY Employed To: MM slash DD slash YYYY If still employed here, don't fill in the date.Hourly Rate/Salary Title And DutiesEmployer Name 2 Employer Phone #Employed From: MM slash DD slash YYYY Employed To: MM slash DD slash YYYY If still employed here, don't fill in the date.Hourly Rate/Salary Title And DutiesEmployer Name 3 Employer Phone #Employed From: MM slash DD slash YYYY Employed To: MM slash DD slash YYYY If still employed here, don't fill in the date.Hourly Rate/Salary Title And DutiesHave you ever been employed by an Ace Hardware* Yes No If yes, when and where* GENERAL INFORMATIONHAVE YOU BEEN CONVICTED OF A FELONY?* Yes No If yes, please explain:*(A conviction will not necessarily disqualify you from employment.)If hired, can you furnish proof you are legally entitled to work in U.S.?*Proof of eligibility will be required upon employment. Yes No PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING BELOW: THIS APPLICATION IS CONSIDERED CURRENT FOR 90 DAYS. IF YOU WANT TO BE CONSIDERED FOR EMPLOYMENT AFTER THIS TIME, YOU MUST RENEW YOUR APPLICATION. I certify that the information contained in this application and/or any supplement thereto, is correct to the best of my knowledge and understand that any misstatement or omission of information is grounds for dismissal in accordance with Company Policy. I authorize Ace Hardware - Big Sky to contact my current or prior employers and/or the above references and request any information concerning my previous employment and any pertinent information they may have, personal or otherwise, and I expressly release Ace Hardware - Big Sky and all parties providing such information from any and all liability or responsibility for damage that may result from furnishing such information. I further understand Ace Hardware - Big Sky may perform a personal/criminal background check which may include verification from the Department of Motor Vehicles and criminal courts. Falsification of information or failure to provide information can result in disqualification or termination if discovered after hire. Several employment interviews may be conducted in order to determine if you are the most qualified candidate and to provide more detailed information regarding your work history and qualifications. If I am offered a position with the Company, I agree to conform to the applicable rules, regulations and policies of the Company, and acknowledge that during the initial 180-day probationary period, or any additional probationary period not to exceed an additional 90 days, my employment and compensation can be terminated at any time with or without cause, and with or without notice, at the option of either the Company or myself. I further understand that no representative of the Company has any authority to make any agreement contrary to the foregoing or to bind the Company for the employment of any person for any specified period of time.Date* SignatureNameThis field is for validation purposes and should be left unchanged.
