2014-12-29 Kevin Jonas Apply to Work at Tom Leonard’s Employment Application If you are human, leave this field blank. Identification First Name * Middle Name Last Name * Address * Street City * City State * State Zip Code * Zip Code How Long Have You Lived At This Address? * Phone * Email Address * Are you either a U.S. Citizen or an alien who has legal right to remain and work in the U.S.? * Yes No (you will be required to furnish proof of lawful work status if you are extended a job offer) Are you at least 16 years old? * Yes No Have you been convicted of a crime other than a traffic violation? * Yes No If yes, please explain and give date, circumstances, nature and disposition of case: Employment Interest Position applying for: Please mark your 1st and 2nd choice. * Bakery Produce Cashier Garden/Seasonal Kitchen/Deli Popcorn OtherOther If you are applying for a management position, please attach resume here. Drop a file here or click to upload Choose File Maximum upload size: 10MB What hours are you available for work? Please indicate day and hours: Mon Tues Wed Thurs Fri Sat Sun Total number of hours willing to work a week: * Would you be willing to work overtime? * Yes No Are you presently employed? * Date you can start work: * Referred by: * Own Initiative Advertising Road Sign Newspaper Flyer in Store School OtherOther Tom Leonard Team MemberTom Leonard Team Member Skills & Education High School * Name & Address Course of Study Last Grade Completed * Did You Graduate? * Yes No Diploma * College Name & Address Course of Study Years Completed Did You Graduate? * Yes No Degree Do you know any team member currently working at Tom Leonard's? * Yes No If yes, whom? Why are you applying to Tom Leonard's? * Work Experience Even if you submit a resume, please list your work experience below, beginning with your present or most recent employer. Please include any summer, part-time or volunteer experience. Present or Most Recent Employer * Dates of Employment * Address * Street City * City State * State Zip Code * Zip Code Name of Immediate Supervisor Phone # Title Department Starting Salary Present/Ending Salary Job Title - Start Job Title - Present/Termination Reason for Leaving/Wanting to Leave Major Responsibilities Add Another Employer Signature Applicant's Signature * Clear Date * Anti-SPAM Tool