Savings
 
 

Application for Employment
Equal access to programs, services and employment is available to all persons.
We ask that anyone requiring reasonable accommodation to the application and/or interview process please let us know immediately.
Please note, all fields in BLUE are REQUIRED:
Position Applying For:
First Name:
Street Address:
Date:
Last Name:
Apt:   City:  
Phone:     -
Cell:      -
State:       Zip:  
 
 
Do you have reliable transportation to and from work?
How many hours per week are you available to work?
Are there any hours you are not available for work?
If so, describe.
Are there any days you are not available for work?
If so, describe.
Have you ever worked for us before, in any location or position?
Dates & Where
 
Do you have a current driver's license?
Please list state and number (if hired, we will need to take a photocopy)
Are you legally eligible for employment in this country?
U.S. immigration laws require (1) Every employer to verify all employee’s proof of identity and legal authorization to work in the U.S. (2) All employees complete an sign an I-9 form and provide proper ID as specified in the law.
Have you ever pleaded "guilty" or "no contest" to, or been convicted of a crime?
The seriousness and nature of any violation, when, rehabilitation and position applied for will be taken into consideration when considering employment possibilities.
  If yes, provide date(s) and details:    
 
 
Please List Any Comments That May Apply -
Comments or Information that may be pertinent in consideration of your application for employment:
Please List Employment History (Starting with your most recent or current employer and going backward by date) -
Employer Name: Start Date: Salary:
Supervisor Name: End Date: Phone:
Reason for Leaving:
Employer Name: Start Date: Salary:
Supervisor Name: End Date: Phone:
Reason for Leaving:
Employer Name: Start Date: Salary:
Supervisor Name: End Date: Phone:
Reason for Leaving:
Employer Name: Start Date: Salary:
Supervisor Name: End Date: Phone:
Reason for Leaving:
Are there any previous employer that you do not wish us to contact?  If so, please explain:
Please List Personal References  -
Name
Phone Number
Relationship
Employment Application Statement -

  I certify that all information I have provided in order to apply for and secure work with CARPET MART is true, complete, and correct.

  I expressly authorize CARPET MART or its representatives to contact, unless otherwise stated; previous employers, personal references   I have provided, public agencies, and licensing authorities to obtain information necessary in the consideration of employment. I waive   any and all rights and claims against CARPET MART, its agents, or any agency or person furnishing such information; for seeking,   gathering, and using truthful information in a lawful manner in the employment process.

  I understand that if a job offer is made, I will be required to submit to a drug test. I further understand that the job offer will be revoked if   the results of such testing is positive. I understand that CARPET MART follows all applicable laws and waive any and all rights and   claims I may have regarding the testing process.

  I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient   to cause (1) eliminate me from further consideration for employment, or (2) may result in my immediate discharge from the employer’s   service, whenever it is discovered.

  CARPET MART does not tolerate unlawful discrimination in its employment practices. No question on its application is used for the   purpose of limiting or excluding an applicant from consideration for employment on the basis of sex, race, color, religion, national origin,   citizenship, age, disability, or any other protected status under applicable federal, state, or local law.
  CARPET MART likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or   any other protected status. CARPET MART takes all complaints of harassment and/or discrimination seriously and all complaints will be   investigated promptly and thoroughly. Proper action will be taken, up to and including termination of employment.

  I certify that I have read, fully understand and accept all terms as stated on this Application.