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901 Michigan Avenue
Sheboygan, WI 53081
(920) 457-5541


Oldest Full Service Hardware Store in Wisconsin

901 Michigan Avenue • Sheboygan, WI 53081 • (920) 457-5541

Employment Form

First and Last Name *:

Home Address *:

Home Phone *:
- -

Primary Email *:

Are you legally eligible for employment in the United States?*

Position Applying For *:

Desired Wage or Salary *:

Date Available to Start (mm/dd/yyyy)*:

Choose Part or Full Time Schedule


EDUCATION

What High School did you graduate from?
(Name of School, City, State) *:

What year did you Graduate *:

Business or Technical School (if applicable):

Degree, Major:

Dates attended:

Personal References (Not employers or relatives) List names, addresses and contact phone numbers for each.*


EMPLOYMENT HISTORY

Employer #1

Name of Company and Supervisor *:

Company Address *:

Company Phone *:
- -

State job title and describe your work *:

Start and End Dates for this job *:

What was your salary or hourly wage? *

What was your reason for leaving? *

Employer #2

Name of Company and Supervisor:

Company Address:

Company Phone:
- -

State job title and describe your work:

Start and End Dates for this job:

What was your salary or hourly wage?

What was your reason for leaving?

Employer #3

Name of Company and Supervisor:

Company Address:

Company Phone:
- -

State job title and describe your work:

Start and End Dates for this job:

What was your salary or hourly wage?

What was your reason for leaving?



Have you ever been convicted of a crime?*

If YES, please explain: (Information will only be used in employment decisions if the conviction is substantially work related.)

Describe why you are seeking employment with our company *:

By submitting this application you are acknowledging the information provided is accurate and complete. You understand that if employed, false statements shall be considered reason for dismissal.