Pharmacy Application Company applying for:*Star MarketStar PharmacyHunnington PharmacyPropst Home HealthPropst DrugTerry's PizzaPlease choose the location(s) you are applying for:* 5 Points Meridianville Madison Bailey Cove Propst Hunnington What position are you applying for?: * Personal InformationDo you currently possess a valid state issued picture identification (driver's license, passport etc): Yes No Are you willing to take a pre-employment drug test? Yes No Name* First Middle Last Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home Phone*Cell Phone*Do you currently use tobacco in any form including but not limited to: cigarettes, dip, chew etc?* Yes No Are any of your relatives or friends presently employed with the company or its divisions?* Yes No If yes, please explain who the relative is:Have you ever applied for the company or its divisions before?* Yes No If yes, where and approximate date: Have you ever worked for the company or its divisions before?* Yes No If yes, where and what date: Can you perform the essential functions of the position for which you are applying for?* Yes No If no, please explain. If you have any questions as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this questionIf you are under 18, please state your age: If under 18 years of age, can you supply working papers?:*SelectYesNoI am over 18Only U.S. citizens and/or aliens who have a legal right to work in the U.S., are eligible for employment. Can you, upon employment, provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?: ** Yes No Have you ever been convicted of a crime or violation other than a minor traffic infraction? A conviction record will not necessarily be a bar to employment. Factors such as job relations, age and time of the offense, seriousness and nature of violation and rehabiliation will be taken into account. If yes, please exlpain below. If no, please skip next section.Explain the crime, date and where it was committed.Have you ever been discharged from any employment or asked to resign? Yes No If yes, please explain below:Availability and RequirementsPlease check which days you are available to work:* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Desired Wage:* Per Hour/SalaryDate available to work: MM slash DD slash YYYY Education HistoryName and location of high school* Have you graduated high school?* Yes No Have you attended a college or university? If so, please state the name and location: Did you graduated college?* Yes No Have you attended any trade, business or correspondence school? If yes, please write the name and degree received:Please list any additional skills, certificate's or training's that you have completed or acquired that might be relevant to the job duties in which you are applying for.Employment HistoryBegin with your most recent employment and continue with all past employment. Enter your last place of employment including dates employed, name, phone number, salary and reason for leaving:List previous employer. Please include: dates employed, business name, contact number, salary and reason for leaving:List previous employer. Please include: dates employed, business name, contact number, salary and reason for leaving:Personal and/or Professional ReferencesPlease list below references including their name, phone number, relationship and years acquainted.Reference:*Reference:*Attendance and Punctuality InformationConsistent attendance and punctuality are essential requirements of every job with this company. Is there anything which would interfere with your regular attendance and punctuality if you are offered a job with the organization?* Yes No If yes, explain below:I certify that all of the information herein is true and correct. I understand and agree that if employed, false, misleading or incorrect statements or material omissions on this application may be sufficient cause for termination at any time and that the Star Discount Pharmacy shall not be liable in any respect if my employment is terminated. I acknowledge that employment with the Star Discount Pharmacy is “at will” and either the Star Discount Pharmacy or I may terminate the employment relationship at any time, with or without cause. I authorize the Star Discount Pharmacy or its agent(s) to investigate all information on this application. I further authorize the Star Discount Pharmacy or its agent(s) to make investigative inquiries and obtain reports such as motor vehicle driving record, criminal background check, or any other inquiries or reports as the Star Discount Pharmacy deems necessary.IT IS THE POLICY OF THE COMPANY TO AFFORD EQUAL OPPORTUNITY TO ALL EMPLOYEES AND APPLICANTS FOR EMPLOYMENT WITHOUT REGARD TO AGE, RACE, RELIGION, COLOR, SEX, NATIONAL ORIGIN, MARITAL STATUS, EXPUNGED JUVENILE RECORDS, OR PREGNANCY, AND TO AFFORD EQUAL OPPORTUNITIES TO DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, AND INDIVIDUALS WITH A DISABILITY, ANY AND OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE OR LOCAL LAW. I AUTHORIZE THE INVESTIGATION OF ALL STATEMENTS AND INFORMATION CONTAINED IN THE APPLICATION. I RELEASE FROM ALL LIABILITY ANYONE SUPPLYING SUCH INFORMATION AND I ALSO RELEASE THE EMPLOYER FROM ALL LIABILITY THAT MIGHT RESULT FROM MAKING AN INVESTIGATION. IF HIRED, I AGREE TO ABIDE BY ALL OF THE COMPANY RULES AND REGULATIONS, AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT THE OPTION OF EITHER THE COMPANY OR ME, I FURTHER UNDERSTAND THAT NO REPRESENTATION, WHETHER ORAL OR WRITTEN BY ANY REPRESENTATIVE OR AGENT OF THE COMPANY, AT ANY TIME, CAN CONSTITUE A CONTRACT OF EMPLOYMENT. I UNDERSTAND THAT THE COMPANY AND ALL PLAN ADMINISTRATORS SHALL HAVE THE MAXIMUM DISCRETION PERMITTED BY LAW TO ADMINISTER, INTERPRET, MODIFY, DISCONTINUE, ENHANCE OR OTHERWISE CHANGE ALL POLICIES, PROCEDURES, BENEFITS OR OTHER TERMS OR CONDITIONS OF EMPLOYMENT. NO REPRESENTATIVE OR AGENT OF THE COMPANY, HAS THE AUTHORITY TO ENTER INTO ANY AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME OR TO MAKE ANY CHANGE IN ANY POLICY, PROCEDURE, BENEFIT OR OTHER TERM OR CONDITION OF EMPLOYMENT OTHER THAT IN A DOCUMENT SIGNED BY THE PRESIDENT OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING. I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS AND HEREBY GRANT PERMISSION TO CONFIRM THE INFORMATION SUPPLIED ON THIS APPLICATION BY ME. BY SELECTING AGREE AND SUBMITTED APPLICATION I AGREE TO ALL OF THE INFORMATION I HAVE GIVEN IS ACCURATE: *Select your answer and submit form* I Agree I Disagree CAPTCHA
