Omaha Store Employment Application

Brown's Shoe Fit Company is an Equal Employment Opportunity employer. We do not discriminate against qualified applicants in hiring or employment on the basis of race, color, religion, creed, national origin, ancestry, gender, marital status, status with regard to public assistance, age, disability, affectional preference or status as a disabled or vietnam-era veteran, or any other status protected by any federal, state, or local statute or ordinance. No question on this application is intended to secure information to be used for such discrimination. The use of this form does not mean that there are positions available and does not obligate Brown's Shoe Fit Company in any way.

Contact Information

First name This field must contain Alpha Numeric characters

Last name This field must contain Alpha Numeric characters

Middle Initial

Street address, Apt. no. This field must contain Alpha Numeric characters

City, State and Zip This field must contain Alpha Numeric characters

Phone number This field must contain Alpha Numeric characters

Email This field must contain Alpha Numeric characters

Are you 18 years of age or older? Yes No

Do you have a valid driver's license? Yes No

List anything else about your contact information you'd like us to know.

Job Preferences

Would you be willing to relocate? Yes No

List any geographical preferences

Select what type of work you're looking for Full time Part time Temporary

What date are you available to start work? You must enter in a date.

Have you been convicted of a felony within the last 7 years? Yes No

If yes, please explain. Conviction doesn't necessarily disqualify applicant for employment.

List anything else about your job preferences you'd like us to know

Education and Experience

Please indicate the highest level of education you have achieved. High School Two-Year Degree Four-Year Degree Post Graduate

Describe any background experience, education, or training which you consider applicable to the position for which you are applying. You have not reached the minimum amount of characters required for this field

List anything else you'd like us to know about your education and experience

Work History

Current or Most Recent Employer

Employer

Street address

City, state and zip

Phone

Supervisor

Dates of employment

Wages

Reasons for leaving

Previous Employer

Employer

Street address

City, state and zip

Phone

Supervisor

Dates of employment

Wages

Reasons for leaving

Willingness Checklist

Part of the activities required to maintain and operate a retail store involve duties or tasks that are often overlooked when describing a specific job. Please indicate your feelings regarding these tasks and duties by selecting your answer to each of these questions.

Would you be willing to do each of the following:

Stock and organize inventory? No Maybe Yes

Dress to our standard every day? No Maybe Yes

Refresh displays throughout the day? No Maybe Yes

Approach all customers with a positive attitude? No Maybe Yes

Maintain a clean work environment? No Maybe Yes

Uphold strict security policies? No Maybe Yes

Smoke in a designated area? No Maybe Yes

Stand on your feet for long periods of time? No Maybe Yes

Operate a calculator and computerized register? No Maybe Yes

Work seasonal, weekend, and evening hours? No Maybe Yes

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete, and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references [personal and professional], employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organization for furnishing such information about me.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves that same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.

If hired, I understand that I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in the regard. I also understand that if I am offered full time employment, I must successfully complete an alcohol/drug screen prior to my hire date.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to 1) eliminate me from further consideration for employment, or 2) may result in my immediate discharge from the employer's service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.

Signature of applicant

Signature date You must enter in a date.

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