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Job Application Form

Personal Information

First Name is required
Last Name is required
Phone Number is required
Street Address is required
City is required
State is required
Zip Code is required
Are you over the age of 18?

Employment Desired

Location
Applying For
Are you legally eligible to work in the U.S.?
Have you previously been employed here?
Are you currently employed?
If "yes", may we inquire of your present employer?

Resume

Education

High School

School Name is required
City is required
State is required
Years Completed is required
Did you graduate?
Did you graduate? is required
Did you graduate? is required

College

School Name is required
City is required
State is required
Years Completed is required
Did you graduate?
Did you graduate? is required
Did you graduate? is required
Degree/G.P.A. is required

Work Experience

Employer Name is required
Location is required
Phone is required
Position is required
Dates of Employment is required
Supervisor is required
Job Responsibilities is required
Reason for Leaving is required
May we contact this employer?
May we contact this employer? is required
May we contact this employer? is required
Employer Name is required
Location is required
Phone is required
Position is required
Dates of Employment is required
Supervisor is required
Job Responsibilities is required
Reason for Leaving is required
May we contact this employer?
May we contact this employer? is required
May we contact this employer? is required
Employer Name is required
Location is required
Phone is required
Position is required
Dates of Employment is required
Supervisor is required
Job Responsibilities is required
Reason for Leaving is required
May we contact this employer?
May we contact this employer? is required

Military Experience

Have you served in the U.S. Armed Forces?
ArmedForces is required
ArmedForces is required
Employer Name is required

References

Name is required
Title is required
Company is required
Phone is required
Name is required
Title is required
Company is required
Phone is required
Name is required
Title is required
Company is required
Phone is required

Authorization

If you are to be hired by the company, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company.

I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employers and all references listed above from any and all claims, demands, or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing.

Powell's Furniture and Mattress may require, depending upon job duties, a medical examination and if I am offered employment I agree to submit to a medical examination before starting work. If employed, I also agree to submit to a medical examination at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will be that I abide by the Company's Drug and Alcohol Policy.

I understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.

You must agree to the Authorization statement