First Name:

Middle Name:

Last Name:

Address:

Address (cont.):

City:

State:

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Zip:

Phone 1: (Primary)

Phone 2:

Email:

Are you 18 years of age or older?

Select One Yes No

Are you legally eligible to be employed in the United States?

Select One Yes No

Other:

Please list any other furniture-related experience, special skills, and/or qualifications:

How many days within a year do you feel is acceptable as time missed from work?

Shift:
Employment Type:
If Part Time, what days/hours?:
How did you find out about this job?

Available Start Date:

Desired Wage:

Desired Incentive:

Select the last grade completed:

8th Grade or less High School 9 High School 10 High School 11 High School 12 College 1 College 2 College 3 College 4

Name and Location of the school(s) above:

Please list any degrees, trade schools, skills or special training:

Current/Most Recent Employer (Name/Address):

Phone:

Start Date:

End Date:

Starting Rate ($/Hr):

Last Rate ($/Hr):

Starting Incentive ($):

Last Incentive ($):

Immediate Supervisor (Name/Position):

Your Job Title and Responsibilities:

Reason for Leaving:

Next Most Recent Employer (Name/Address):

Phone:

Start Date:

End Date:

Starting Rate ($/Hr):

Last Rate ($/Hr):

Starting Incentive ($):

Last Incentive ($):

Immediate Supervisor (Name/Position):

Your Job Title and Responsibilities:

Reason for Leaving:

Next Most Recent Employer (Name/Address):

Phone:

Start Date:

End Date:

Starting Rate ($/Hr):

Last Rate ($/Hr):

Starting Incentive ($):

Last Incentive ($):

Immediate Supervisor (Name/Position):

Your Job Title and Responsibilities:

Reason for Leaving:

Read Carefully and sign below...

• I hereby certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge.
• I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, previous employment record, and credit history.
• I release all such persons from any liability or damages on account of having furnished such information.
• I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Shenandoah Furniture and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Shenandoah Furniture unless made in writing.
• If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that Shenandoah Furniture retains the same right.
• I understand that if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies and procedures, in whole or in part, at any time.
• I understand that this application will be kept on active file for 90 days from the date completed, after which time I would have to reapply in accordance with established company procedures.
• **ALL APPLICANTS MUST SUCCESSFULLY PASS A PRE-EMPLOYMENT DRUG TEST BEFORE BEING HIRED**