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Fill out an Application
General Information
Position to which you are applying
Salary Desired
Last Name
First Name
Middle Name
Prior names, if any
Street Address
City
State
Zip Code
Home phone
Buisness Phone
Cell Phone
Email address
Social Security Number
Have you applied to Associated Brands before?
Yes
No
If yes, give date
Have you ever been employed here before?
Yes
No
If yes, give date
Are you over 18 years of age ?
Yes
No
Are you currently employed?
Yes
No
If yes, may we contact your employer?
Yes
No
Are you authorized to work in the United States?
Yes
No
Employment desired:
Full-Time
Part-Time
Temporary
Summer
Please indicate the date you are available to begin work
Are you able to work overtime?
Yes
No
What shifts are you willing to work?
First Shift
Second Shift
Third Shift
Can you travel if it is a requirement of the position?
Yes
No
Have you ever been convicted of a misdemeanor or a felony in any jurisdiction?
Yes
No
Are there any criminal charges pending against you?
Yes
No
If you answered “Yes” to either question, please explain (convictions or pending charges do not necessarily bar you from employment):
Education
High School
Name and Location of High School
No. of Years Completed
Major & Degree
Major Subjects or Specialization
College
Name and Location of a College
No. of Years Completed at a College
Major & Degree at a College
Major Subjects or Specialization at a College
Vocational School
Name and location of Vocational School
No. of years completed at vocational school
Major & Degree
Major subjects or specialization at vocational school
Other Schools
Name and location of other school
No. of years completed at other school
Major & Degree at other school
Major Subjects or Specialization at other school
Computer Skills
PC User
Mac User
Windows
Email
Internet
Web Page Design/Maintenance
MS Word
MS Excel
MA Access
MS Power Point
MS Publisher
Other
Driver License – Only complete this section if you are applying for a position which requires driving
Do you have a valid Driver License?
Yes
No
State of Issue
Expiration Date
If you answered “Yes,” please answer the following
Has your drivers’ license ever been revoked or suspended?
Yes
No
Have you been convicted of any moving violations within the last 3 years?
Yes
No
Have you ever been convicted of DWI or DUI?
Yes
No
Have you had a motor vehicle accident in the past 3 years which caused property damage or personal injury while driving?
Yes
No
Military
Are you a veteran of the United States military service?
Yes
No
Branch
If yes, Date Entered
Date Discharged
If yes, please describe any relevant skills or training acquired
Briefly explain why you desire to be employed by Associated Brands, Inc. and why you feel you are qualified for the position for which you are applying.
Why you desire to be employed by Associated Brands
References – Only list references who are familiar with your work. Do not include friends or relatives.
Name
Working Relationship
Phone number
Occupation/Company
Name 2
Working Relationship 2
Phone Number 2
Occupation/Company 2
Employment History
May we contact your former employer(s)?
Yes
No
Employer 1
Name of Employer
Employer Address (No., Street, City, State, Zip code)
Type of Business
Telephone Number
Your Position
Duties
Date Employed (Month, Day, Year)
Date Left (Month, Day, Year)
Beginning Salary
Ending Salary:
Reason for Leaving
Supervisor Name
Employer 2
Name of Employer 2
Employer Address (No., Street, City, State, Zip code) 2
Type of Business 2
Telephone Number 2
Duties 2
Date Employed (Month, Day, Year) 2
Date Left (Month, Day, Year) 2
Beginning Salary 2
Ending Salary 2
Reason for Leaving 2
Supervisor Name 2
Employer 3
Name of Employer 3
Employer Address (No., Street, City, State, Zip code) 3
Type of Business 3
Telephone Number 3
Duties 3
Date Employed (Month, Day, Year) 3
Date Left (Month, Day, Year) 3
Beginning Salary 3
Ending Salary 3
Reason for Leaving 3
Supervisor Name 3
Employer 4
Name of Employer 4
Employer Address (No., Street, City, State, Zip code) 4
Type of Business 4
Telephone Number 4
Duties 4
Date Employed (Month, Day, Year) 4
Date Left (Month, Day, Year) 4
Beginning Salary 4
Ending Salary 4
Supervisor Name 4
I have read and agree to the terms of agreement
Agreement
I understand that misstatements, false responses, or omissions made by me in this application shall be cause for denial of employment or discharge. I hereby release ABI from any and all liability of whatever kind and nature which, at any time, could result from having an employment decision based on such information.
I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of ABI. However, I further understand that neither the policies, rules, regulations of employment, nor anything said during the interview process shall be deemed to constitute the terms of an express or implied employment contract. I understand that any employment offered is for an indefinite duration and at-will in accordance with law. As a matter of practice, however, ABI discharges only for cause or other legitimate business reasons. I also understand that this written statement supersedes any and all oral representations made by agents or representatives of ABI.
I understand that if offered a position with ABI, I may be required to submit to a pre-employment medical examination, drug screening, and background investigation as a condition of employment. I understand results from, refusal to cooperate with, or any attempt to affect the results of these pre-employment checks may result in withdrawal of any employment offer or termination of my employment.