Application for Employment Name(Required) First Middle Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you lived at the current address(Required) Phone(Required)Email(Required) Are you over the age of 18?(Required)YesNoIf no, when will you be turning 18?(Required) Are you a U.S. citizen or are you otherwise authorized to work in the U.S. without any restriction?(Required)YesNoHave you ever been convicted of a crime?(Required)YesNoBackground checks are run on all potential employees so please answer honestly.If yes, explain number of convictions, nature of offense, leading to convictions, how recently such offenses were committed, sentence imposed and types of rehabilitation(Required)Are you involved in any extra-curricular activities which might prohibit you from attending work?Sports, social groups, etcPosition(s) applied for(Required) Cashier Candy Department Bakery Assistant Baker Cake Decorator Desired Hours Per Week(Required)10-1515-2020-3030-4040+Desired Work Week(Required)Monday-FridayWeekends OnlyAnySome weekends but mostly weekdaysDo you have experience working a lottery machine?(Required)YesNoPlease list two references. Include full name, phone number and relationship with the person.(Required)Experience in the field applying for(Required)None6 months or lessone year or less1-2 years2-4 years4-5 years5-10 years10 years or morePlease list your qualifications for the position(s) you have appliedPrevious Work ExperiencePlease list: Company Name, Supervisor Name, Phone Number, Dates of Employment, Starting and Ending SalaryAre you currently employed?(Required)YesNoResume UploadMax. file size: 32 MB.Consent(Required) I agree to the privacy policy.I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed one year. any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee can resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand also, that I am required to abide by all rules and regulations of the employer. We are committed to provide opportunities for all persons without regard to sex, race, creed, religion, ethnic background, or handicap in its programs, policies, or employment practices. PhoneThis field is for validation purposes and should be left unchanged. Δ