Career Application - Lusby Hardware

Job Details

Position Applied For

Salary Desired

Referral Source

Personal Information

* Indicated required field

Personal Information

First Name *

Middle Name *

Last Name *

Phone *

Email *

Address *

City *

State/Province *

Zip *

Education

What is the highest level of education have you completed? * Middle School
High School
College/University

If college, what is your degree?

Specialized training, skills, or abilities

Languages other than English you can speak, read, and/or write

Employment History

Are you currently employed? YesNo

Current Employer (or most recent employer)

Employer Name

Type of Business

Employer Phone

Address

City

State/Province

Zip

Date of Employment (start date) (mm/yyyy)

Date of Employment (end date) (mm/yyyy)

Exact Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer? YesNo

Description of duties, responsibilities and equipment operated

Liked Most About Job

Liked Least About Job

Reason for Leaving

Final Pay

$ Per

Previous Employer 1

Employer Name

Type of Business

Employer Phone

Address

City

State/Province

Zip

Date of Employment (start date) (mm/yyyy)

Date of Employment (end date) (mm/yyyy)

Exact Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer? YesNo

Description of duties, responsibilities and equipment operated

Liked Most About Job

Liked Least About Job

Reason for Leaving

Final Pay

$ Per

Previous Employer 2

Employer Name

Type of Business

Employer Phone

Address

City

State/Province

Zip

Date of Employment (start date) (mm/yyyy)

Date of Employment (end date) (mm/yyyy)

Exact Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer? YesNo

Description of duties, responsibilities and equipment operated

Liked Most About Job

Liked Least About Job

Reason for Leaving

Final Pay

$ Per

Previous Employer 3

Employer Name

Type of Business

Employer Phone

Address

City

State/Province

Zip

Date of Employment (start date) (mm/yyyy)

Date of Employment (end date) (mm/yyyy)

Exact Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer? YesNo

Description of duties, responsibilities and equipment operated

Liked Most About Job

Liked Least About Job

Reason for Leaving

Final Pay

$ Per

Check All That Apply

Are you legally eligible to work in the U.S.A? YesNo

On what date would you be available to work?* / Days Availble / Years Availble (mm/dd/yyyy)

Are you available to work? *

Full Time
Part Time
Weekends
3rd Shift
1st Shift
Overtime
Seasonal Employment Only

What days are you available to work? *

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Do any of your relatives work for this company?

YesNo
If yes, who?
Relationship

Have you previously worked for Lusby Hardware? YesNo

Have you been convicted of a felony?

YesNo
If yes, please explain where, when, and disposition of case:
(Conviction will not necessarily disqualify an applicant from employment.)

Have you served in the U.S. Armed Forces or National Guard?

YesNo
Describe your experience

Do you have a valid driver's license? YesNo

If yes, State/Province issued

License Number

Any dates of driver's license suspensions

Do you have reliable transportation? YesNo

Professional References

Reference 1

Name

Title

Phone Number

Describe Your Relationship to this Reference

Resumé

Resume

Upload Resume and optional Cover Letter.

(Please submit a single PDF or Microsoft Word file)

How did you learn of this job opening?

Walk-in
Advertisement - Newspaper
Advertisement - Internet
Other Government Agency
School/College
Employment Agency
Search Form
Employee Referral - Name of Employee: Employee Referral
Other - Specify: Other - Specify

Applicant's Statement

I have reviewed the job description for this position and (check one):

I am able to meet all of the job requirements for this position.
I am able to meet all of the job requirements for this position, except as follows:
Statement

Submission

By checking this box and submitting this electronic application, I affirm that I have read and I agree to the conditions of the application above, and that all information I have provided in this application is correct and complete to the best of my knowledge.

Do you agree?* Yes, I agree.