PETLAND DISCOUNTS, INC.
EMPLOYMENT APPLICATION

Please type Your Info.In The White Boxes & Check Off the appropriate boxes below and
Click On The Submit Button.
Personal

First Name:
Last Name:
Present Address:
City:
State:
Zip:
Phone:
e-mail Address:
Are you over 18 ? Yes
No
No, but I have working papers.
Do You have the legal right to be employed in the United States?  Yes
No
Have you ever been convicted of a crime (excluding minor traffic violations)? Yes
No

If Yes, please describe.

(Note: A conviction will not necessarily disqualify you from employment.)
Do you have a Drivers License? Yes
No

Employment Desired

Are you seeking? Full-time
Part-time   
Temporary or summer employment
Date available to start?
Position applied for?
Salary Desired?
Have you ever applied to our company before? Yes
No
Have you ever worked for our company before? Yes
No
If your answer to either of the above questions is Yes, state when and where you applied and/or worked.
Are there any days or hours you would be unable or unwilling to work? Yes
No
If Yes, please specify those days or hours you would be unable or unwilling to work.

Education

Name/address/location: Dates: Graduated? Courses Studied:
High School

XXXXXX
YES
NO
College
 		From-To:
YES
NO
Trade School
 		From-To:
YES
NO
If you did not graduate, why did you leave high school or college?
Are you planning to pursue further studies? Yes
No
If so, when, where and what courses?
List and describe any other school, specialized, or military training.

Personal References

Name: Address: Phone: Relationship:

Capability / Reliability

Would you be able and willing to perform all of the
tasks required by the job you are appling for?		 Yes
No
If not, explain which tasks.
Have you filed any type of fraudulent claim against any of your present or past employers? Yes
No
If Yes, explain.
Have you ever been disciplined for violating company rules and regulations? Yes
No
If Yes, explain.
Would you be willing and able to report to work on time every day on a regular and consistent basis? Yes
No
If No, please explain.

Work History

List names of last three employers in condecutive order
with present or last employer listed first.

May we contact these employers? Yes
 No

Company: Supervisor: From: Salary:
/Yr
Address: Phone: To:
Reason for Leaving: Duties:


Company: Supervisor: From: Salary:
/Yr
Address: Phone: To:
Reason for Leaving: Duties:


Company: Supervisor: From: Salary:
/Yr
Address: Phone: To:
Reason for Leaving: Duties:
Do you own any pets? Yes
No
If Yes, please describe.
Do you have any cash register or computer experience or
training?		 Yes
No
If Yes, describe.

Use this space below to describe any skills or abilities which you feel will qualify you for a position with our company.

Agreement

I understand/agree by hitting the "submit my Information" button below that 
I agree with the following
  Affidavit:

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever.  I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form of during any interviews may be grounds for my immediate discharge.

I agree that, if I am employed, I will abide by all the rules and regulations of the company.  I UNDERSTAND THAT NOTHING IN THIS APPLICATIONS IS A PROMISE OR CONTRACT OF EMPLOYMENT.  I FURTHER UNDERSTAND THAT, IF I AM EMPLOYED, NY EMPLOYMENT IS "AT-WILL" AND MAY BE TERMINATED BY MYSELF OR BY THE COMPANY OR ANY REASON, WITH OR WITHOUT PRIOR NOTICE.

I hereby authorize the Company to contact any company or individual it deems appropriate to Investigate my employment history, character and qualifications and I give my full complete concent to their revealing any and all information they wish as a result of this investigation.

I understand that this application will be kept on active file for 90 days from the date it is completed.  If I reapply for employment after that date, I will be required to complete a new application in accordance with establish Company practices.

I understand that Petland Discounts, Inc. has made a commitment for a work environment that is drug free and that a National Institute of Drug Abuse (NIDA) certified drug examination is a precondition of employment or promotion for all management candidates.  The NIDA Chain of Custody procedures will be utilized to ensure that there is no tampering with the specimen.  The lab will test specimen to determine if their is any evidence of drugs.  On an as-needed basis, the GC/MS method will be used as additional confirmation in order to fully comply with all laws and provide total confidence in the drug test results.  By submitting this application, I consent to submit to a drug examination if I am offered employment in a management position.

I further understand that in accordance with applicable law, an investigative or consumer report may be sought.  If such reports are sought, the Company will notify me in a separate written communication of the name and address of the credit reporting agency and take such other steps as may be required by law.

PLEASE HIT THE SUBMIT BUTTOM BELOW TO SEND YOUR COMPLETED EMPLOYEMENT APPLICATION TO US: