Employment Application Form Employment Application Form "*" indicates required fields Cobwebs Inc. 487 Gateway Avenue Chambersburg, PA 17201 (717) 263-6161AN EQUAL OPPORTUNITY EMPLOYER NOTICE: Applicants should read the following information carefully before filling out any of the questions in this form. In accordance with Title VII of the Civil Rights Act of 1964, we do not discriminate because of race, color, sex, religion, national origin, age (if over 40 years of age), handicap, disability, marital status, or unfavorable military discharge.Date of Completion* MM slash DD slash YYYY Todays DateName* First Middle Last Email PhoneSocial Security Number* Yes No Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you applying for Full-time Part-time Shifts you can work Any (8am-7pm) 2pm-7pm 4pm-7pm Days you can work: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Saturday and Sunday availability is required.If you were to be hired- what are your intentions of staying with our company? What are your future goals?Why should we hire you? Why are you the right person for this position?Hire is subject to PA Labor Laws. Age:Are you under the age of 18?* Yes No Do you have a work permit? If hired, can you provide the documents required to prove you are authorized to work in the United States?* Yes No Have you ever been convicted of any crimes, other than minor traffic violations ?* Yes No If Yes the nature of the crime(s), when and where convicted and disposition of the case: “will explain at interview” is not acceptable“will explain at interview” is not acceptableHigh School Diploma? Yes No College/University Other/Trade Employment: (start with the most recent or current)Name of Firm Town/City & Phone Number: Dates Start Date / End DateSupervisor First Last Reason for Leaving Submit Another Job Reference? Yes No Name of Firm Town/City & Phone Number: Dates Start Date / End DateSupervisor First Last Reason for Leaving Submit Another Job Reference? Yes No Name of Firm Town/City & Phone Number: Dates Start Date / End DateSupervisor First Last Reason for Leaving Personal References: List below 2 persons you have known for at least one year. DO NOT LIST RELATIVES Name First Last PhoneNumber of Years Acquainted How you know this person Name First Last PhoneNumber of Years Acquainted How you know this person Conditions of Employment: You must be willing and able to accept the conditions listed below in order to be successful in this job. If you are not willing or able to accept ALL of these conditions; do not apply. By submitting your application, you are indicating you are willing and able to: work on Saturday and Sunday. Normal workweek is seven days a week including Saturday and Sunday. Normal store hours are 8 am until 7 pm. Work schedules are subject to change. Employee will unload shipments of merchandise and live animals. This involves lifting, carrying and stacking, using a hand truck, and climbing a ladder. You must also lift and carry merchandise up to 50 pounds. Employee will be responsible for using a manual and computerized cash register and being financially responsible for the money in the cash drawer. Employee will be responsible for custodial duties, such as sweeping, dusting, mopping, cleaning windows and lavatories, and removing ice and snow. Employee is responsible for handling and caring for puppies, kittens, small animals, fish, birds and reptiles. I understand that the company will thoroughly investigate my work and personal history and verify all data given on the application, on related papers, in interviews. I authorize all individuals, school, and firms named within, except my current employer if so noted, to provide any information requested about me, and I release them from liability for damage in providing this information. I understand that nothing contained in the application or conveyed during any interview which may be granted is intended to create an employment contract between me and The Pet Store. In addition, I understand and agree, if I am employed, my employment is for no definite or determinable period and may be terminated at any time, without prior notice, at the option of either myself or The Pet Store, and that no promises or representations contrary to the foregoing are binding on The Pet Store unless made in writing and signed by me and the Company President. ALL EMPLOYMENT IS BASED ON A 90-DAY PROBATIONARY PERIOD. APPLICANT’S NAME First Last Today's Date MM slash DD slash YYYY Download/Print Application
