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Styles For Less is an Equal Opportunity Employer. To be employed by Styles For Less you must be 18 years of age. This application for employment shall be considered active for a period of 60 days. Personal Information Last Name First Name Middle Initial Address City State Zip code Home Telephone Business Telephone E-mail Address Social Security Number Position Primary Position Desired Other Position Desired Salary Desired Hours Available (Enter the hours your available for each day of the week) Date Available Mon. Tues. Wed. Thur. Fri. Sat. Sun. Full-Time Part-Time Other What or who referred you to apply at Styles For Less? Have you ever applied for a position with Styles For Less (If yes, when?) Have your ever worked for Styles For Less? (If yes, when and what location?) Are you currently employed? Yes No Education School School Name No.Years Completed Degree Major Course of Study High School College Grad. School Trade/Bus/Night or Correspondence Other Employment History In the following spaces give a complete record of the last 10 years of your employment including periods of unemployment and/or military job experience, if any. Begin with your most recent employment and work back. Company Name Telephone Employed From (Mo.Yr.) To (Mo./Yr.) Address City State Zip code Last Position Held Other Positions Held Supervisor's Name & Title Last Salary Current Salary List Duties and Responsibilities Reason For Leaving   Company Name Telephone Employed From (Mo.Yr.) To (Mo./Yr.) Address City State Zip code Last Position Held Other Positions Held Supervisor's Name & Title Last Salary Current Salary   List Duties and Responsibilities Reason For Leaving   Company Name Telephone Employed From (Mo.Yr.) To (Mo./Yr.) Address City State Zip code Last Position Held Other Positions Held Supervisor's Name & Title Last Salary Current Salary   List Duties and Responsibilities Reason For Leaving   Additional Employment Information Additional Inquiries May we contact your present employer? Yes No May we contact any of your previous employers? Yes No Please identify any exceptions and reasons why we may not contact any of your employers? In order to permit verification of your work and education records, identify any other name(s) and relevant dates during which you used the name(s). Have you ever been terminated, dismissed or forced to resign from any employment? Yes No If yes, please identify name(s) and relevant dates and the reason for action taken against you. Military Experience Have you ever served in the U.S. Armed Forces? Yes No Describe any special job-related training received. Other Special Skills Describe any other special job-related skills or qualifications (e.g. foreign languages, computers, professional associations, etc.) that would support your application. Experience Summary Dictaphone Switchboard Telex Telecopier Photocopier Mail Room File Room Messenger Videotape Equip. Other Word Processing -Types Computers - Types Programming Languages General Information If employment is offered, can you submit a birth certificate, social security card, certificate of U.S. citizenship or verification of your legal right to work in the U.S.? Yes No Are your over 18 years of age? Yes No Do you have any physical or mental disability which may limit your ability to perform the job applied for? Yes No If yes, please explain and describe what can be done to accommodate your limitation in order for you to perform the functions essential for the position. Have you ever been convicted of a felony? (An affirmative response will not automatically disquallify you from being considered as a candidate for employment.) Yes No If yes, please list conviction(s).  Include dates and places. Are you willing to work overtime as requested? (This information will be used for job related reasons only.  As a condition of employment, certain position may require overtime and/or weekend work.) Yes No Emergency Contact Last Name First Name     Address City State Zip code Home Telephone Business Telephone

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