Employment Application - Premier Couples Superstore - Sex Toys, Costumes, Bachelorette Supplies

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EMPLOYMENT APPLICATION

(Pre-Employment Questionnaire) (Equal Opportunity Employer)

Please fill out the application below and we will get back with you.

Step 1 of 2 - First Page

Your Name*
Prefix First Last Suffix
Address*
Street Address City State ZIP Code
Phone Number*
Email Address*
Enter Your Email Confirm Your Email
Are You 21 Years or Older?*
- Yes
- No
According To Florida Law, We Cannot Hire You If You're Not At Least 21 Years Old
THE QUESTIONS IN THIS FRAMED AREA ARE REQUIRED INFORMATION FOR AN OCCUPATIONAL QUALIFICATION OR DICTATED BY NATIONAL SECURITY LAWS OR NEEDED FOR OTHER LEGALLY PERMISSIBLE REASONS.
Date of Birth ✠*
Month
Day
Year
SPECIAL QUESTIONS:
Height What Foreign Languages Do You Speak Fluently?
Are you prevented from lawfully becoming employed in the U.S.?*
- Yes
- No
Have you ever been arrested or convicted in the last 5 years if so please explain below: ✠✠*
- Yes
- No
Explain:*
✠ The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.
✠✠ You will not be denied employment solely because of a conviction record, unless the offense is related to the job for which you have applied.
EMPLOYMENT DESIRED:*
Position Date You Can Start Salary Desired
Do You Have Retail Sales Experience?*
- Yes
- No
If Yes, What Store(s)?*
Write the name(s) of the store(s) where you have worked in retail sales.
What dates did you work?
What were your duties? Explain in detail.
Are You Employed Now?*
- Yes
- No
If So, Can We Contact Your Present Employer?*
- Yes
- No
Ever Applied To This Company Before?*
- Yes
- No
*
When? Where?
Are You Looking For Full Time Or Part Time?*
- Full Time
- Part Time
List Which Days and Times You're Available to Work:*
Click the PLUS ➕ button to add more rows/days.
Days of the Week Times
Are You Looking To Work Day Shift, Night Shift Or Either?*
Please make sure the hours below work for your schedule.
- Day Shift - 8:45 AM - 5:15 PM
- Night Shift - 4:45 PM - 1:15 AM (Friday and Saturday until 2:15 AM)
- Either
Do You Have Reliable Transportation?*
- Yes
- No
EDUCATION:
HIGH SCHOOL:*
Name and Location Of School No. of Years Attended Did You Graduate? Subjects Studied
COLLEGE:
Name and Location Of School No. of Years Attended Did You Graduate? Subjects Studied
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL
Name and Location of School No. Of Years Attended Did You Graduate? Subjects Studied
GENERAL:
Subjects of Special Study, Research Work or Other Skills
MILITARY SERVICE ✠
US Military or Naval Service Rank Present Membership in National Guard or Reserves

FORMER EMPLOYERS
FORMER EMPLOYERS (List Below Last 4 Employers, Starting With Last One First)*
From - To (Mo/Yr) Name & Address of Employer Phone Number of Employer Salary Position Reason For Leaving
From - To (Mo/Yr) Name & Address of Employer Phone Number of Employer Salary Position Reason For Leaving
From - To (Mo/Yr) Name & Address of Employer Phone Number of Employer Salary Position Reason For Leaving
From - To (Mo/Yr) Name & Address of Employer Phone Number of Employer Salary Position Reason For Leaving
REFERENCES:*
(Give the Names of Three People Not Related to You and Whom You Have Known at Least One Year)
Name Address Phone Number Years Acquainted
*
Name Address Phone Number Years Acquainted
*
Name Address Phone Number Years Acquainted
PHYSICAL RECORD:
Do You Have Any Physical Limitations That Prevent You From Performing Any Work For Which You Are Applying For?*
- Yes
- No
If Yes, What Can Be Done To Accommodate Your Limitation?*
IN CASE OF EMERGENCY, NOTIFY:*
Name Address Phone Number
Upload Your Resume:
Accepted file types: pdf, doc, docx, Max. file size: 64 MB.
I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE 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 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 ALL PARTIES FROM All LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING SAME TO YOU, I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PRIOR NOTICE.
Your Signature:*
Electronic Signatures have a legal status equivalent to a written signature.