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Application

PRICE BUSTERS hires only U.S. citizens and lawfully authorized alien workers. The law prohibits discrimination because of race, color, religion, sex, age, national origin, or a disabled condition which may be reasonably accomodated.

WE CONDUCT PRE-EMPLOYMENT DRUG SCREENING

Position Applying For

A value is required.

Location: Please select an item.

Personal

First Name:
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Middle Name:
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Last Name:
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Street Address:
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City:
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State:
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Zip Code:
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Social Security Number:
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Home Phone:
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Work/Pager/Cellular Phone:
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Availability

What led you to contact us for employment?:
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Date available for employment:
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Position applying for:
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Location applying for:
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Total hour per week (Total hours scheduled are at the discretion of management):
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Hours Available Sunday: Monday: Tuesday: Wednesday: Thursday: Friday: Saturday:
From A value is required. A value is required. A value is required. A value is required. A value is required. A value is required. A value is required.
To A value is required. A value is required. A value is required. A value is required. A value is required. A value is required. A value is required.
 
Are you seeking seasonal employment?:
Please make a selection.
If yes, for how long? From:
To:
If hired, is there anything that may prevent you from reporting to
work each scheduled day on time?:
Please make a selection.

If yes, please explain:

 

Miscellaneous

Have you worked for PRICE BUSTERS previously?:

Please make a selection.
If yes, please indicate dates:
From: To:
Reason for leaving:
Location:
Supervisor:
Have you worked in a retail environment before?:

Please make a selection.
If yes, where and for how long? Dates?:
Do you have family/relatives that work for PRICE BUSTERS/E.R.T. SALES?:

Please make a selection.
If yes, please state their name, relationship to you and where they work:
Are you able to perform all the essential functions of the
job for which you are applying with or without accomodation?:

Please make a selection.
If hired, do you agree to abide by the safety rules of the company?:

Please make a selection.
Have you ever been denied a driver's license,
or had your license revoked or suspended?:

Please make a selection.
If yes, explain:

 

Education

Type of School Name and Location No. of Years Attended Graduated
High School


College


Technical


Are you currently enrolled in school?:


If yes, please give name and location:

 

Work History

Begin with your most recent employer and account for your last three jobs or the last 7 years, whichever is shorter. If you worked under a different name, please indicate.

Have you ever worked before :
Please make a selection.
 
Employer's Name:
Street Address:
City:
State:
Zip Code:
Phone:
Dates of Employment (Mo./Day/Year):
From: To:
Position/Duties:
Type: Name of Immediate Supervisor:
Hourly Pay:
Starting: Present/Final:
Reason for leaving:
 
Employer's Name:
Street Address:
City:
State:
Zip Code:
Phone:
Dates of Employment (Mo./Day/Year):
From: To:
Position/Duties:
Type : Name of Immediate Supervisor:
Hourly Pay:
Starting: Present/Final:
Reason for Leaving:
 
Employer's Name:
Street Address:
City:
State:
Zip Code:
Phone:
Dates of Employment (Mo./Day/Year):
From: To:
Position/Duties:
Type: Name of Immediate Supervisor:
Hourly Pay:
Starting: Present/Final:
Reason for Leaving:

 

References (Professional preferred, no relatives)

Name:
Occupation:
Address:
Telephone No.:
 
Name:
Occupation:
Address:
Telephone No.:
 
Name:
Occupation:
Address:
Telephone No.:

 

Please make a selection. By checking this box I certify that all statements made on this application are true and complete to the best of my knowledge. I understand that my application will not be considered if it is incomplete. Further, I understand that any misrepresentation or omission when discovered, will subject me to discharge and I hereby authorize any investigation of the above or related work exprerience, education, or reputation information for purposes of consideration of my application for employment.

 

 



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