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Personal Information
Last Name
First Name
Middle Initial
Street Address
City
State
Zip Code
Home Phone
Secondary Phone
Extension #
Email Address
Position Information
Position Applying For
Status Desired
Choose Option
Full-time
Part-time
Temporary
Expected Earnings
Per
Hour
Month
Year
Date Available to Start
Do you have the ability to perform the essential functions of the job you are applying for with or without reasonable accommodation?
Accomodations
Yes
No
Schedule Availability
Enter the times your are available for each day below. (i.e. 9:00am - 5:00pm)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Education Information
High School / GED Name & Location
Years Completed
Did you graduate?
Yes
No
College / University name & Location
Years Completed
Major Area of Study
Did you graduate?
Yes
No
Use the following box to tell us about any other education or additional training you have received which may be relevant to this job.
Other Education / Training
General Information
Can you provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?
Legal to Work in U.S.
Yes
No
Are you at least 16 years of age or older?
At least 16?
Yes
No
If you are not at least 16, what is your current age?
Current Age
Have you been convicted of a crime in the last 10 years?
crime?
Yes
No
If you answered 'Yes' to the last question, please explain below...
Crime Conviction
Do you know anyone who is currently employed by The Orchard? If yes, list that associate's full name.
Referral
Have you ever worked with this company before? If yes, please list the store location, time period, and your reason for leaving.
Company History
Emploment History
For the following, please be sure to include ALL of the following: Company Name, Street Address, City, State, Zip Code, Employment Start & End Dates, Supervisor's Name, Your Job Title & Description, Starting Pay-Rate, Ending Pay-Rate, and your Reason for Leaving.
Current / Most Recent Employer
Next Previous Employer
Next Previous Employer
References
Enter your professional references below. (No family members). Please include for each: First and Last Name, Occupation, Phone Number, and Time Known.
Reference 1
Reference 2
Reference 3
Other
In the text area below, please include any other experience (i.e. Military), References, and / or Why you are a good fit to our team.
Other Information
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