Now Wear This!
406 Hershey Road
Elizabethtown, PA 17022
717-361-0535
EMPLOYMENT APPLICATION
APPLICANT DATA Date___________________
Address:_____________________________________City:___________________________________State:________Zip:_________
Phone:________________________Cell Phone:_____________________________E-Mail _________________________________
Date Available to Start:_________________________________Social Security #__________________________________________
Salary Requirement:__________________ # Hours/week available______________________________________________________
Are you available: Daytime_____________________Evenings_____________________Weekends__________________________
Type of employment desired: □ Full-Time □ Part-Time □ Seasonal
If you are under 18 and we require a work permit, can you furnish one? □ yes □ no
If no, please explain___________________________________________________________________________________________
Have you ever pled “guilty”, “no contest”, or been convicted of a crime? □Yes □No
If yes give dates & details_______________________________________________________________________________________
____________________________________________________________________________________________________________
Answering “yes” to these questions does not constitute an automatic rejection for employment. Date of the offense,
seriousness and nature of the violation will be considered.
EDUCATION:
High School:___________________________________________Address:______________________________________________
# of Years Completed:____________Did you Graduate? □ Yes □ No
College/University:______________________________________Address:______________________________________________
# of Years Completed:____________ Did You Graduate? □ Yes □ No Degree:_____________________________
Major:_______________________________
Other:_________________________________________________Address:_____________________________________________
# of Years Completed:_____________Did You Graduate? □ Yes □ No Degree:_____________________________
Major:_______________________________
REFERENCES
Please furnish the names, addresses and telephone numbers of two people to whom you are not related and by whom you have not been employed.
Name:_______________________________________Phone:_______________________________________
Address:_____________________________________City:____________________State:_____Zip:_________
Name:_______________________________________Phone:________________________________________
Address:_____________________________________City:____________________State_____Zip:_________
SUMMARIZE YOUR HOBBIES, INTERESTS, SPECIAL SKILLS OR QUALIFICATIONS:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
PREVIOUS EMPLOYMENT (begin with most recent position)
Firm:_________________________________________Address:_____________________________________________
Phone:_____________________ Supervisor:______________________________Title:___________________________
Responsibilities:_____________________________________________________________________________________
__________________________________________________________________________________________________
Starting Salary & Title:_______________________________Ending Salary & Title______________________________
Reason for Leaving__________________________________________________________________________________
May we contact this employer for a reference? □ Yes □ No
Dates of Employment: From ____/____/____ To ____/____/____ Position_____________________________________
Firm:_________________________________________Address:_____________________________________________
Phone:_____________________ Supervisor:______________________________Title:___________________________
Responsibilities:_____________________________________________________________________________________
__________________________________________________________________________________________________
Starting Salary & Title:______________________________Ending Salary & Title_______________________________
Reason for Leaving__________________________________________________________________________________
May we contact this employer for a reference? □ Yes □ No
Dates of Employment: From ____/____/____ To ____/____/____ Position_____________________________________
Firm:_________________________________________Address:_____________________________________________
Phone:_____________________ Supervisor:______________________________Title:___________________________
Responsibilities:_____________________________________________________________________________________
__________________________________________________________________________________________________
Starting Salary & Title:_____________________________Ending Salary & Title________________________________
Reason for Leaving__________________________________________________________________________________
May we contact this employer for a reference? □ Yes □ No
Please be aware that Now Wear This, Inc. is a non-smoking facility, smoking in the building or on the property by employees is prohibited during all scheduled working hours.
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, or medical history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or persons from all liability when responding to inquiries in connection with my application.
In the event I am employed, I understand that false or misleading information given in my application or interview may result in discharge.
Signature of Applicant:__________________________________Date:_____________________________