Big R Stores
Application For Employment

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, ancestry, marital status, sexual orientation, or any other legally protected status under applicable local, state or federal law.

Store

Fallon NV Burns OR Winnemucca NV Lovelock NV Fernley NV

Positions(s) Applied For

How did you learn about us?

Advertisement Friend Walk-in Employment Agency Relative Other

Last Name

First Name

Middle Name

Address   Number   Street

City

State

Zip

Telephone Number(s)

If you are under 18 years of age, can you provide required proof of your eligibility to work?

Yes No

Have you ever filed an application with us before?

Yes No

If Yes, give date

Have you ever been employed with us before?

Yes No

If Yes, give date

Are you currently employed?

Yes No

May we contact your present employer?

Yes No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

Yes No

Proof of employment Authorization and identity will be required upon employment.

On what date would you be available for work?

Are you available to work?

Full Time Part Time Shift Work Temporary

Are you currently on "lay-off" status and subject to recall?

Yes No

Can you travel if the job requires it?

Yes No

Have you been convicted of a felony within the last 7 years?

Yes No

Conviction will not necessarily disqualify an applicant from employment. The regency, severity, and pertinence of the conviction to the job will be considered.

If yes, please explain:

We are an equal opportunity employer

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer

Address

Work Performed

Telephone Number(s)

Dates Employed

Hourly Rate/Salary

From

To

Starting

Final

Supervisor

Employer

Address

Work Performed

Telephone Number(s)

Dates Employed

Hourly Rate/Salary

From

To

Starting

Final

Supervisor

Employer

Address

Work Performed

Telephone Number(s)

Dates Employed

Hourly Rate/Salary

From

To

Starting

Final

Supervisor

References

List professional, trade, business or civic activities and offices held.
You may exclude membership which reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

Name

Phone#

Address

Name

Phone#

Address

Education

Please list education or specialized experience that relates to the position(s) for which you are applying. Exclude names or terms which indicate, for example, race, color, religion, sex, disability, or national origin.

Name & Address of School Course Study Years Completed Diploma Degree
Elementary School
High School
Undergraduate
Post Graduate

Describe any specialized training, apprenticeship skills, and extra-curricular activities applicable to the job for which you are applying.

Additional Information

Other qualifications: Summarize special job-related skills and qualifications acquired from employment or other experience.

Specialized Skills

Check skills/Equipment Operated

A/P Purchasing

Production / Mobile

Other (list):

CRT Fax

Machinery (list):

PC Activant/Epicor
Calculator Microsoft Suites
Typewriter

State any additional information you feel may be helpful to us in considering your application.



Applicant's Statement

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. I release from all liability all persons, companies, and corporations providing such information, either in writing or orally. I also indemnify this Company against any liability which might result from making such investigation.

This application for employment shall be considered active for a period of time not to exceed 45 days. 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, any employment relationship with this organization is of an "at will" nature, which means that the Employee may 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. I understand that this application is not a contract.

In the event of employment, I understand that false or misleading information given in my application or interview (s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the employer.


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