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Application For Employment

The Civil Rights Act of 1994 prohibits discrimination in employment because of race, religion, or national origin. Public Law 90-202 prohibits discrimination because of age. Pet Supermarket is an Equal Opportunity Employer. Pet Supermarket does not discriminate in employment and no question on this application will be for the purpose of limiting or excluding any applicant's consideration for employment on any basis prohibited by local, state or federal law.


Employment Objective Why do you wish to work for Pet Supermarket?



Applicant Information



Criminal Record

ARE YOU AWAITING TRAIL OR AS AN ADULT, HAVE YOU BEEN CONVICTED OF A CRIME OR PLED GUILTY TO A CRIME (OTHER THAN A MINOR TRAFFIC VIOLATION) RESULTING IN A CONVICTION, WHICH CONVICTION HAS NOT BEEN ANNULLED, ERASED, EXPUNGED, VACATED, SET ASIDE, OR SEALED BY THE COURT? YOUR ANSWER WILL BE VERIFIED AGAINST LOCAL, STATE AND FEDERAL RECORDS AS PERMITTED BY LAW. ANSWERING "YES" WILL NOT NECESSARILY DISQUALIFY AN APPLICANT FOR EMPLOYMENT. THIS INFORMATION WILL BE USED ONLY FOR JOB RELATED PURPOSES AND ONLY TO THE EXTENT PERMITTED AND APPLICABLE BY LAW. ALL FACTORS WILL BE CONSIDERED, INCLUDING THE NATURE OF THE OFFENSE, THE SEVERITY, AND THE DATE OF THE OFFENSE IN RELATION TO YOUR SUITABILITY FOR THE POSITION FOR WHICH YOU HAVE APPLIED. IF YOUR ANSWER IS "YES", PLEASE EXPLAIN THE CIRCUMSTANCES SURROUNDING SUCH OFFENSE.


GEORGIA APPLICANTS ONLY: Applicant need not disclose any conviction that is considered a first offender discharge under ' 42-8-63 of the Georgia Code, which covers first offenses for which you received only probation

Application to the following stores

Separate multiple stores by comma(,)


Please list all hours you are available for work

(Please use 24 hour format. E.g. 8am = 800, 1pm = 1300, 8pm = 2000)

Any = Available to work during any hours. N/A = Not Available for work.









Desired Salary (do not leave blank)

$

Essential Job Functions

PET SUPERMARKET RETAIL AND WAREHOUSE LOCATIONS REQUIRE THE ABILITY TO PERFORM THE FOLLOWING ESSENTIAL JOB FUNCTIONS. (CHECK ALL OF THE FOLLOWING YOU COULD PERFORM, GIVEN REASONABLE ACCOMODATION)


List any special qualifications for this postition


List any pet related experience

Employment History most recent first

1.

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$



2.

$


$



3.

$


$


Education




Drug Policy, Certification, Authorization and Signature






Signature



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