Employment Application - Amigo Pawn and Jewelry

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AMIGO PAWN & JEWELRY
EMPLOYMENT APPLICATION FORM
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
PLEASE COMPLETE PAGES 1-3.
Date:
B
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Name:
Last
Present Address:
First
Number
How Long:
Middle
Street
How many addresses in last 5 years?
Telephone: Home:
Cell:
City
State
Social Security No.:
Work:
Zip
Are you a U.S. citizen or resident?
 Yes
I
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c
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 No  Yes
Do you smoke?
 No
 Yes
Days/Hours Available to Work: No Preference: 
Shifts Preferred: __________________________________________
 No
 Yes
Shifts Unavailable: ________________________________________
2
Salary Desired:
When are you available to start? _____________________________
0
Have you worked for this organization before?
 No  Yes
How many hours can you work weekly? ______________________
1
Have you ever been discharged or asked to resign from any position
Employment Desired:  Full Time  Part Time  Temporary
0
 No
 Yes If Yes, please explain_________________________________________
.
How many days have you missed from school or work in the last 12
__________________________________________________________________________
Are you at least 16 years of age?
Position(s) Applying For:
Are you currently employed?
 No
Maiden
__________________________________________________________________________
How did you find out about this job? Referred by:_______________________________
Newspaper

months? _____________
A
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______________________________________________________________
Other:_________________________________
EDUCATION & OTHER INFORMATION
LOCATION
(Complete mailing address)
NAME OF SCHOOL
Been late:______________
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Explain: ______________________________________________________
LEVEL
COMPLETED
High School
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MAJOR & DEGREE
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College
Bus. or Trade School
Professional School
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(A) Have you ever been convicted of a crime (other than traffic violations)?
 No
 Yes
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(B) Bonding and licensing policies require that we ask you if you have ever been convicted of a felony:
 No
 Yes
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Are you on parole?
 No
 Yes
or awaiting trial?
 No
 Yes
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If answering yes for ANY part of (A) or (B) above, explain the conviction(s), the nature of offense(s) leading to conviction(s), how recently such offense(s) were
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committed, sentence(s) imposed, and type(s) of rehabilitation. The existence of a criminal record does not constitute an automatic bar to employment. Please be
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honest.
d
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y
Do you have a driver’s license?
 Yes
 No
Do you have reliable means of transportation to work?
Yes
 No
ID or Driver’s License Number (specify which):
State of issue:
 Operator  Commercial (CDL) Chauffeur
Have you had any accidents in the past three years?
 No
 Yes
If yes, how many?
Have you had any moving violations during the past three years?
 No
 Yes
If yes, how many?
Computer Proficiency
Typing
Personal
Computer
 Yes
 No
 Yes
 No
_____ WPM
PC
Mac
10-key  Yes
Word
 No
Processing

Other Computer Skills:

 Yes
 No
_____ WPM
Expiration Date:
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Please list two references other than relatives or previous employers.
Name:
Position:
Company:
Address:
Name:
Position:
Company:
Address:
Telephone:
Telephone:
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to add any
additional information necessary to describe your full qualifications for the specific position for which you are applying. Feel free to attach a resume.
MILITARY
Have you ever been in the armed forces?
Are you now a member of the national guard?
Specialty:
Work History
 Yes
 Yes
Date Entered:
 No
 No
Discharge Date:
Please list your last 3 employers. Begin with the most recent employer.
Job One
Name of Employer:
Name of Last Supervisor
Complete Address:
Phone Number:
Reason for Leaving (be specific):
Employment Dates
From:
Start:
Salary
To:
Final:
Your Last Job Title:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Job Two
Name of Employer:
Name of Last Supervisor:
Complete Address:
Phone Number:
Reason for Leaving (be specific):
Employment Dates
From:
Start:
Salary
To:
Final:
Your Last Job Title:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Job Three
Name of Employer:
Name of Last Supervisor:
Employment Dates
From:
Start:
Salary
To:
Final:
Complete Address:
Phone Number:
Reason for Leaving (be specific):
Your Last Job Title:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Why are you seeking a new position at this time?
Outside interests, including organizations you’re active in that are business related:
What is the job you have enjoyed most and why?
Did you complete this application yourself?
If not, who did?
 Yes  No
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PLEASE READ CAREFULLY
APPLICATION FORM WAIVER
In exchange for the consideration of my job application by the staff leasing company for Amigo Pawn & Jewelry, Amigo Consultants, Inc.
(hereinafter called “the Company”), I agree that:
Neither the acceptance of this application, nor the subsequent entry into any type of employment relationship, either in the position applied
for or any other position regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements and the like
as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to
confer any right to remain an employee of Amigo Pawn & Jewelry, or otherwise to change in any respect the employment-at-will
relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President
of the Company. Both the undersigned and Amigo Consultants, Inc. may end the employment relationship at any time, without specified
notice or reason. If employed, I understand that the Company may unilaterally change wages, revise their benefits, conditions, policies and
procedures and such changes may include reduction in benefits.
I authorize investigation of all statements contained in this application, and I release from all liability all companies and corporations
supplying such information. I understand that the misrepresentation or omission of facts called for is cause for denial of employment or
dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers,
references, and others, and hereby release the Company from any liability as a result of such contact.
I hereby agree to submit to any drug test that may be required of me whether prior to my employment or if employed by this company at
any time thereafter. If requested I will take a physical examination, post job offer, and employment will be conditional upon passing such
examination. During such employment, I understand and agree that in the event that I receive medical treatment for any condition,
including a physical, psychological, emotional, or psychiatric condition that is job related, I hereby authorize the limited release and
exchange of such medical information relating to my condition between the treatment provider and a company designated physician.
I understand that, in connection with the routine processing of an employment application, the Company may request from a consumer
reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal
characteristics and mode of living. Upon written request from me, the Company will provide me with additional information concerning
the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.
I further understand that my employment with the Company shall be probationary for a period of ninety (90) days, and further that at any
time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either
party.
Please write “I read this” at the top of page one (1) before returning to the store management.
I have read and understand the above.
Applicant’s Signature:
Date:
This Company is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color,
religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with
this Company depends solely on your qualifications.
Thank you for completing this application form and for your interest in our business.
DO NOT WRITE BELOW THIS LINE
Remarks
___________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
Neatness
Character
Personality
Ability
Hired
 Part Time  Full Time
Store
Position
Start Date
3
Wages