employment

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To apply at any of the 13 PUFF DISCOUNT TOBACCO locations you may fill out our online application below or print the form and return it to one of the locations!

Today's Date
Full Name
Address I
Address II
City
State
Zip Code
Phone Number
Cell Number
Date of Birth (optional)
Driver's License Number (if applicable)
If you are under 18 and we require a work permit, can you furnish one? YesNo
Have you ever worked for this company? YesNo
If yes, when?
Are you a citizen of the United States? YesNo
If not, are you legally allowed to work in the United States? YesNo
Type of Employment Desired
List Location Preferred
Have you ever worked a cash register before? YesNo
If yes, where?
Have you ever worked lottery before? YesNo
If yes, where?
Puff Discount Tobacco pays by direct deposit, do you have a bank account? YesNo
Upon hiring, do you have a problem having your checks direct deposited into you bank account? YesNo
If yes, please explain
Briefly list any special skills that may assist us if you should be hired.
Education
High School attended
# of years completed
Did you graduate? YesNo
College/University attended
# of years completed
Did you graduate? YesNo
In what field?
Other Schooling/or Armed Forces # of years completed
Did you complete your course of study? YesNo
Previous Employement
Name of Employer
Phone Number
Address
Date you began with company?
Date you ended with company?
Supervisors Name
May we contact this person? YesNo
Previous Employment 2
Name of Employer
Phone Number
Address
Date you began with company?
Date you ended with company?
Supervisor's Name
May we contact this person? YesNo
References: Please list 3 persons not related to you that we may call as references.
Reference 1
Name
Phone Number
How do you know this person?
Reference 2
Name
Phone Number
How do you know this person?
Reference 3
Name
Phone Number
How do you know this person?
Have you ever "pled guilty", "no contest" or been convicted of a crime? YesNo
If yes, give dates & details

I certify that my answers are true and complete to the best of my knowledge, I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, or medical history and other related matters as may be necessary for an employment decision.

I hereby release employers, schools or persons from all liability when responding to inquiries in connection with my application.

In the event that I am employed, I understand that false or misleading information given in my application or interview may result in discharge.

Do you agree to comply with the statement above? YesNo
Type your initials for online signature of application