Employment Application

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Date Available *

Desired Salary *

Position Applying For *

Are you a citizen of the United States? *

Yes No

If no, are you authorized to work in the U.S.? *

Yes No N/A

Have you ever worked for Randy's Hardware, Inc. before? *

Yes No

If yes, when? *

Have you ever been convicted of a felony? *

Yes No

If yes, explain *

Are you able to work nights and weekends? *

Yes No

If no, explain *

Are you able to lift up to 100 lbs.? *

Yes No

If no, explain *

Note: Randy's Hardware, Inc. is an equal opportunity employer in compliance with all federal, state, and local laws. As such, Randy's Hardware, Inc. will not discriminate based on the answers you provide to these questions.

High School *

From - To *

Location *

Did you graduate? *

Yes No

College/Trade School *

From - To *

Location *

Did you graduate? *

Yes No

Other *

From - To *

Location *

Did you graduate? *

Yes No

Please list three professional references.

Responsibilities *

May we contact your previous supervisor? *

Yes No

Responsibilities *

May we contact your previous supervisor? *

Yes No

Responsibilities *

May we contact your previous supervisor? *

Yes No

Have you served in the US Military? *

Yes No

If yes, what branch? *

When? *

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By clicking "SUBMIT" below, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

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TIMBERVILLE, VIRGINIA | (540) 896-5403
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