EMPLOYMENT APPLICATION

EQUAL OPPORTUNITY EMPLOYER.  It is our policy to abide by all Federal and State laws prohibiting employment discrimination solely on the basis of a person's race, color, creed, national origin, religion, age (over 40), sex marital status, or physical or mental disability, except where a reasonable, bona fide occupational qualification exists.

Job Requirments: You must have a car. Your must have a cell phone. You must be willing to take random in-store drug tests. If you do not meet any of the requirements, please DO NOT APPLY.

EMAIL ADDRESS
Do you have a car? "car is required"
Do you have a cell phone? "cell is required "

 NameSecurity #

 Address How Long?

 City StateZip Code

 Day Phone     Home Phone

 Position for which you are applying

 Check the following options you would consider Full Time Part Time Other

 If Part Time, specify hours or days

 What is your minimum salary requirement?Date available for work

 Do you have any commitments to another employer that might affect your employment with us?

 

EDUCATION AND TRAINING

 


School Name


City and State

Degree/
Major Course Study


Degree Recieved

 

High School

 

 

 

 

College            

 

 

 

 

 

Graduate School

 

 

 

 

 

Trade School

 

 

 

 

 

List any other education, training, special skills or certificates licenses that you possess related to the job




List any machines, equipment, or software programs on which you are qualified and experienced in operating.


List any languages that you fluently speak Read/Write

Do you have a valid driver's license in this state?           Driver’s License #

Military experience ? if yes what branch and what rank

GENERAL INFORMATION
Can you, after employment, submit verification of your legal right to work permanently in the U.S.
Are you 16 years old or over?                 If under 18, state age
During the last ten years, have you ever been convicted of, plead quality to, or received probation, deferred adjudication, or any other type of alternative method of supervision or correction for a felony or a misdemeanor, having a penalty of imprisonment or a fine of over $500?  (Answering yes is not an automatic bar to employment but will be considered in relation to specific job requirements.)
If yes, explain

EMPLOYMENT HISTORY 1
List all work experience beginning with present or most recent job (use back of application, if necessary)

Name of employer Type of Business

Address City  State Zip

Dates employed (From – to)Title

Name and Title of supervisor Te

May we contact them? ?    Was employment Part Time or  Full Time?

Brief Description of Duties

Reason for Leaving

EMPLOYMENT HISTORY 2
List all work experience beginning with present or most recent job (use back of application, if necessary)

Name of employer Type of Business

Address City  State Zip

Dates employed (From – to)Title

Name and Title of supervisor Te

May we contact them? ?   Was employment Part Time or  Full Time?

Brief Description of Duties

Reason for Leaving

EMPLOYMENT HISTORY 3
 List all work experience beginning with present or most recent job (use back of application, if necessary)

Name of employer Type of Business

Address City  State Zip

Dates employed (From – to)Title

Name and Title of supervisor Te

May we contact them? ?   Was employment Part Time or  Full Time?

Brief Description of Duties

Reason for Leaving

 REFERENCES (List three individuals, in addition to listed employment references, know to you for at least three years)

NAME                                       OCCUPATION/ASSOCIATION       PHONE

Person to be notified in case of emergency:

Name            Telephone

Address

Please include any other information you thank would be helpful to us in considering you for employment, such as additional work experience, articles/books published, activities, honors received, etc.  (You may omit all information that would indicate age, sex, sexual orientation, race, religion, color, national origin, disabilities.)

AGREEMENT (Please read the following statement carefully.)

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to be the best of my knowledge.  I also agree that falsified information or significant omissions may disqualify me from further consideration for employment and any be considered justification for dismissal if discovered at a later date.

I authorize all persons listed above (and on the accompanying resume, in any) to give Planet Cyber any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, suck persons and Planet Cyber, from liability for any damage that may result from furnishing same to Planet Cyber.

If employed by Planet Cyber, i agree to abide by the policies and procedures of Planet Cyber.  I further understand that my employment can be terminated, with or without cause or notice, at any time, at the discretion of Planet Cyber,.  I further understand that no manager or representative or Planet Cyber has authority to enter into any agreement, oral or written, on behalf of Planet Cyber for a term of employment or to make any assurance or promise of continued employment.

I understand and agree that I may be required to take a drug and alcohol screening test.  I herby give my voluntary consent for a blood and/or urine sample to be collected from me and submitted for testing.  I also consent to the release of the test result to Planet Cyber for its use.  I understand that any positive drug or alcohol result may preclude my employment.