Personal information (Información Personal) First name Last name MI Address Apt # State City Zip Code Application Date Social security number E-mail address Home Phone number Cell Phone number If offered employment, can you provide verification of your legal right to work in the United States?YesNo General information (Información General) Applying for Salary Desired Date available to Work Are you at least 18 years old?YesNo How were you referred to us? SeekingFull timePart-timeSeasonalTemporary Have you ever been previously employed by Phoenix or its affiliates?YesNoIf yes, what year, location and state: Do you have any relatives employed by Phoenix or its affiliates?YesNoIf yes, what store location and state Where you ever employed under a different name or social security number?YesNoIf yes, what name and #: Do you have reliable transportation?YesNoType: Have you ever been convicted of a criminal offense - felony or serious misdemeanor (excluding convictions for marijuana-related offenses that are more than 2 years old)? (Please note: A conviction will not necessarily disqualify you for employment)YesNo Are you able to perform the essential duties of the position for which you are applying for with or without reasonable accommodations?YesNoIf no, please indicate what type(s) of reasonable accommodations are needed: Availability (Disponibilidad) Can you work weekends?YesNo Can you work overtime, if needed? what shift(s) are you available to work?DayEveSwingGraveyard Hours available per week MondayFromTo TuesdayFromTo WednesdayFromTo ThursdayFromTo FridayFromTo SaturdayFromTo SundayFromTo Education (Educación) Name and State of School Did you graduate?Yes or No Certificate / Major / Degree High School College / University Tech / Trade / Military Other Other related course or training relate to position: Skills and Abilities (Habilidades) Do you have any computer skills?YesNoLevelAdvancedIntermediateBasicBeginner what software (if any) are you familiar with? others skills, Abilities, Languages:
