Online application
 Personal Information    * Required Fields
* How were you referred:
   Store Locations (Please Choose One)

Lansing Mall - Lansing
        (517) 327-0658
Rivertown Crossing - Grandville
        (616) 530-2674
Crossroads Mall - Portage
        (269) 324-2757
Lakeview Square Mall - Battle Creek
        (269) 979-8455
Fashion Square Mall - Saginaw
        (989) 790-0166
Birchwood Mall - Fort Gratiot
        (810) 385-2243
Lakeside Mall - Sterling Heights
        (586) 566-0132  
 

* Please list times you are available to work
ex. [ 9am to 10pm ]

Mon.
Tues.
Wed.
Thur.
Fri.
Sat.
Sun.

 
* Full Name:
* Address:
* City:
* State:
* Zip:
* Your E-mail:
* Phone:    [ex. 555-555-5555]
* Cell/Other:    [ex. 555-555-5555]
* 18 Years Or Older:
* If no, can you furnish a work permit?
* Position Desired: Sales Associate
* Date You Can Start:
* Pay desired:
* Applied here before:
* If YES, where and when:
* Currently employed?
* If YES, may we contact your present employer?
* Type of employment:


* Have you ever pleaded guilty, no contest, or been convicted of a crime?
* If YES, give dates/details:
Answering "yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

Summarize Your Special Skills or Qualifications:
 
 Education History
 School Name  Location  Years Attended  Degree
 Previous Employment (begin with most recent position):
Dates of Employment: From:   To:    [MM/YYYY]
Positions(s) Held:
Firm / Company: 
Address of Employer:    [Street, City, State, and ZIP code]
Phone Number:    [ex. 555-555-5555]
Supervisor:
Title of Supervisor:
Your Responsibilities:
Starting Salary & Title:
Ending Salary and Title:
Reason for Leaving:
May we contact this employer for reference? Yes     No
 
Previous Employment
Dates of Employment: From:   To:    [MM/YYYY]
Positions(s) Held:
Firm / Company: 
Address of Employer:    [Street, City, State, and ZIP code]
Phone Number:    [ex. 555-555-5555]
Supervisor:
Title of Supervisor:
Your Responsibilities:
Starting Salary & Title:
Ending Salary and Title:
Reason for Leaving:
May we contact this employer for reference? Yes     No
 
Previous Employment
Dates of Employment: From:   To:    [MM/YYYY]
Positions(s) Held:
Firm / Company: 
Address of Employer:    [Street, City, State, and ZIP code]
Phone Number:    [ex. 555-555-5555]
Supervisor:
Title of Supervisor:
Your Responsibilities:
Starting Salary & Title:
Ending Salary and Title:
Reason for Leaving:
May we contact this employer for reference? Yes     No
 
 References (list below the names of three persons not related to you, whom you have known at least one year)
Name Years Known Business Phone Number
 


APPLICANT'S STATEMENT

AUTHORIZATION

"I certify that the facts contained in this application are true to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from the utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

 


I agree to the AUTHORIZATION