APPLICATION FOR EMPLOYMENT Applicants are not required to

Store Address
The Mall at Partridge Creek
17380 Hall Road
Clinton Township, MI 48038
Hiring Office
17420 Hall Road, Space 147
Clinton Township, MI 48038
(Located in the mall across from the
Play Park towards Carson's)
Hiring Office Hours
Monday-Friday: 9am-6pm
Saturday: 9am-3pm
For More Information - [email protected]
APPLICATION FOR EMPLOYMENT
Applicants are not required to give any information prohibited by law. Our employment policies are non-discriminatory with
respect to age, sex, sexual orientation, creed, color, national origin, disability, religion, citizenship status, disabled veteran, or
veteran status or other legally protected status.
Position
Applying For
Application
Date
Date Available
to Start
Name:
Last
First
Middle
Present Address
Street
City
State
Zip
Telephone
E-mail address
Home: (
)
Cell: (
Are you 18 years old or older?
Yes
No
Are there any hours or days of the week you cannot work?
If so, when?
Desired Pay
Type of
Employment
Have you ever
applied to this
Company
before?
Education
$__________ per hour
Full-time
Part-time
Yes
Yes
)
No
per year
No
Where?
School and Address
When?
# Years
Attended
Did you Graduate?
Subject/Major
High School
College
Specialized
Training
Please provide any additional information such as special skills, training, management experience, equipment operation, or qualifications you
feel will be helpful to us in considering your application:
Are you legally permitted to work in the United States without restrictions? No
Yes
Have you ever been convicted of any offense in any court except for a minor traffic violation?
If so, please the date and place, charge and disposition where offense occurred:
PROFESSIONAL/
PERSONAL
REFERENCES:
CURRENT AND
FORMER
EMPLOYERS:
(Most Recent
First)
Name
Dates: Month/Year
May we contact the employers listed? Yes
If not, which one(s) and why not?
Address/Phone
Employer (name,
phone, address)
No
Yes
# Years Acquainted
Salary (Starting/Ending)
Position Held
Relationship
Reason for
Leaving
No
Please read the following statement carefully before signing to indicate your understanding:
 I understand that prior to being offered employment I may be requested to take an employment examination. In the event that I have
a disability that will affect my ability to take the test, I will so inform the Company prior to the administration of the test so that a
reasonable accommodation can be made. Post employment offer, the Company reserves the right to require medical documentation
regarding the need for accommodation.
 I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if
employed falsified statements on this application may result in termination.
 I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my
wages and salary, be terminated with or without cause, at any time, with or without notice.
 I authorize BlackFinn to investigate all information in this application and to secure additional information in the course of that
investigation. I authorize all references, and any other persons contacted, to answer all questions asked related to my ability,
reputation, character and previous employment record.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
Date
Signature
4/6/15