Holiday Wholesale | Employment Application

This employer is an equal employment opportunity employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, national origin, marital status, ancestry, citizenship, veteran status, sexual orientation or preference, or physical or mental disability.

PERSONAL INFORMATION

Last, First, MI

Today's Date

Address

City

Zip

Phone

Referred By

Position Applying For

Salary Desired

Shift Desired

Seasonal

Temporary

Full Time

Part Time

Do you have a valid driver's license?

Yes

Have you ever interviewed with this employer or its affiliates before?

Yes

If yes, list date(s), job title(s), and location(s)

Have you ever been employed by this employer or its affiliates before?

Yes

If yes, list date(s), job title(s), and location(s)

Are you at least 18 years old?

Yes

If under 18, do you have a work permit?

Yes

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court? (If YES, response does not automatically disqualify your application)

Yes

EDUCATION

Do you have a high school diploma?

Yes

If "NO", do you have your GED?

Yes

School Name

City/Location

If "NO", indicate highest grade completed

Do you type?

Yes

Words per minute?

College/University, Vocational, Business, Other

Address

Major Studies

Degree, Diploma, License, or Certificate

Other Special Knowledge, Skills, or Qualifications

Are you currently on "lay-off" status and subject to recall?

Yes

When are you available to work?

What is the best time to contact you at home?

Do NOT answer this question unless you have been informed about the requirements of the job for which you are applying.

Are you capable of performing in a reasonable manner, with or without reasonable accommodation, the activities involved in the job or occupation for which you have applied?

Yes

EMPLOYMENT #1

Employer

Immediate Supervisor

Nature of work performed/responsibilities

May we contact this employer?

Yes

Salary

Reason for Leaving

Job Title

Telephone & Address

From (MM/YYYY) to (MM/YYYY)

EMPLOYMENT #2

From (MM/YYYY) to (MM/YYYY)

Employer

Job Title

Telephone & Address

Immediate Supervisor

Nature of work performed/responsibilities

May we contact this employer?

Yes

Salary

Reason for Leaving

EMPLOYMENT #3

From (MM/YYYY) to (MM/YYYY)

Employer

Job Title

Telephone & Address

Immediate Supervisor

Nature of work performed/responsibilities

May we contact this employer?

Yes

Salary

Reason for Leaving

Reference #1

Name

Occupation

Phone

Reference #2

Name

Occupation

Phone

Reference #3

Name

Occupation

Phone

CERTIFICATION & AUTHORIZATION

The above information is true and correct. I understand that, in the event of my employment by this employer, I shall be subject to dismissal
if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested,
regardless of the time elapsed after discovery.

I authorize this employer to inquire into my education, professional and past employment history references as needed to research my
qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to this
employer and will hold this employer and my former employer harmless from any claim made on the basis of such information about me
which was provided or that any employment decision was made on the basis of such information. I further authorize this employer to obtain
any credit, consumer check, or legal background check. I understand that a placement medical examination, based on the requirements of
the position for which I am being considered, may be required and a pre-employment drug test may also be required.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with this employer is
intended to create an employment contract between myself and this employer which my employment could be terminated only for cause. On
the contrary, I understand and agree that, if hired, my employment will be terminable at will and may be terminated by myself, or this
employer at any time and for any reason. I further understand that this “at will” employment relationship may not be changed by any
written document or by conduct unless, such a change is specifically acknowledged in writing by an authorized executive of this organization.

This employment application shall be kept active for 45 days. Beyond 45 days, applicants must inquire if applications are being accepted and
may need to reapply.

If employed, I will be required to provide original documents, which verify my identity and right to work in the United States under the
Immigration Reform and Control Act (IRCA) if 1986. The document(s) provided will be used for completion of Form I-9.

Note: Your Social Security Number will be required for consideration.

I hereby acknowledge that I have read and agree to the above statements.

Digital Signature

Date

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