Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *FirstLastE-mail Address *Present Address *Number - Street - City - State - Zip How long at address above?Phone Number *Are you 18 or older? *YesNoPosition Applied For *Salary Desired *Days Available to Work *MondayTuesdayWednesdayThursdayFridaySaturdaySundayCheck all days that you are available to work.How many hours can you work weekly? *Can you work nights? *Employment Desired *Full-Time OnlyPart-Time OnlyFull-Time or Part-TimeWhen are you available to start working? *Schooling Completed *High SchoolCollegeBusiness or Trade SchoolProfessional SchoolName of School - School Mailing Address - Number of Years Completed - Major & Degree *Please list the Name of your school, it's complete mailing address, the number of years you completed, and your major & degree above.Have you ever been convicted of a crime? *YesNoIf yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation in the box below. Have you ever been in the Armed Forces?YesNoAre you now a member of the National Guard?YesNoSpecialty - Date Entered - Discharge DateIf you have ever been in the armed forces, please list your specialty, the date you entered, and your discharge date in the box above.Work Experience (Past Five Years) *Name of Employer - Job Title - Start Date - End Date - Duties/Responsibilities of Salary Number Work Experience (Continued)Any additional Work Experience that doesn't fit in the above section can go here.May we contact your present employer? *YesNoDid you complete this application yourself? *YesNoIf not, who did?Do you have a drivers license? *YesNoDriver's License NumberState of IssueExpiration DateType of LicenseOperatorCommercial (CDL)ChauffeurWhat is your means of transportation to work? *Have you had any accidents during the pas three years? If yes, how many?Have you had any moving violations during the past three years? If yes, how many?Reference One (Not a relative or previous employer) *Name - Company - Position - Address - TelephoneReference Two (Not a relative or previous employer) *Name - Company - Position - Address - TelephoneRelevant ExperienceAn application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space above to summarize any additional information necessary to describe your full qualifications for the specific positions for which you are applying.Drug Test Acknowledgement *By filling your name above, you agree that you understand that as part of the drug testing process for Donaldson Enterprises dba Sam's Furniture, they will conduct a drug test to determine your suitability for the position in which you are applying or currently hold. You understand that a negative drug test result is a condition of employment. You understand that if you refuse to undergo the testing, you may be rejected for employment. You understand that if you produce a positive test result for illegal drug use and/or alcohol, you may be rejected for employment or termination from employment. You understand that if you produce a positive test result for illegal drug use that information may be forwarded to the Central Drug Registry maintained by the Division of State Police. Information from the registry can be made available by court order or as part of a confidential investigation relating to employment with a criminal justice agency. By filling your name above, you declare that you have read and understand the information contained on this "Acknowledgment Form".Submit Application
