"*" indicates required fields Applicant’s InformationName* First Last Nickname PhoneEmail Alternate Phone Number Work Cell Other 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 Position Applying ForAvailable to WorkFull-timePart-timeSpecify Shift Preferences 1st Shift 2nd Shift 3rd Shift What days and hours are you available to work?Mondays from: Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM Tuesdays from: Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM Thursdays from Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM Fridays from Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM Saturdays from Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM Sundays from Hours : Minutes AM PM AM/PM To: Hours : Minutes AM PM AM/PM How did you learn about this company and position? Job advertisement (identify publication or other media): Employee referral (identify employee): Other (please specify): Have you previously worked at our company? Yes No If yes, under what conditions did you leave employment before?For each level of schooling below, please write the school name, the city and state where it is located, your major and minor subjects, and the degree or diploma you received.Graduate SchoolHigh School College 1 College 2 Business, Trade, or Other Schools Work HistoryStarting with your current or most recent employer, please provide the following information about the last three companies for which you have worked.Employer 1 (current or most recent) Company Name Address Dates Employed MM slash DD slash YYYY Job Title(s) Held Job Responsibilities Name of Immediate Supervisor(s) Employer 2 Company Name Address Dates Employed MM slash DD slash YYYY Job Title(s) Held Job Responsibilities Name of Immediate Supervisor(s) Employer 3 Company Name Address Dates Employed Job Title(s) Held Job Responsibilities Name of Immediate Supervisor(s) Applicant ConsentPlease carefully read the statements below and initial each one to indicate that you understand and agree to the terms stated. Then sign this form at the bottom.I certify that all information I have supplied on this form is correct to the best of my knowledge. I understand that omissions or providing deliberate misinformation will disqualify my application and, if hired, would serve as grounds for dismissal.* I certify that all information I have supplied on this form is correct to the best of my knowledge. I understand that omissions or providing deliberate misinformation will disqualify my application and, if hired, would serve as grounds for dismissal. Consent* I give consent to BABE'S HARDWARE OF VENICE INC to contact the employers listed on this form for my employment references. I authorize these individuals to provide truthful information regarding my employment and previous work experience. In doing so, I waive liability against the employers and individuals contacted as my references, provided the information they supply is honest, factual and given without malice.*CAPTCHA Δ