The Buckeye Corner - Employment Form

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· AUTOMOTIVE
· CARDS
· FOOD AND BEVERAGES
· GIFT BASKETS
· GIFT CARDS
· GIFTWARE
· HOME DECOR
· INFANTS
· JEWELRY
· KIDS ACCESSORIES
· MEN'S
· NIKE INFANTS
· NIKE MENS
· NIKE TODDLER BOYS
· NIKE TODDLER GIRLS
· NIKE WOMENS/JUNIORS
· NIKE YTH/CHILD BOYS
· NIKE YTH/CHILD GIRLS
· PETS
· SCHOLARSHIP FASHIONS
· SPIRIT
· SPORTS PROD/ACCESSOR
· TODDLER BOYS
· TODDLER GIRLS
· UNISEX WEAR
· WOMENS/JUNIORS
· YOUTH/CHILD BOYS
· YOUTH/CHILD GIRLS

Application for Employment
Are you interested in employment opportunities at the Buckeye Corner. Please complete and submit the form below. If you would prefer to fax in your appliction you can do so by clicking the .pdf link below and either mailing it or faxing it to the address below.

The Buckeye Corner
Attn: Human Resources
460 Schrock Rd. Suite F
Columbus, OH 43229
(614) 540-7116 Fax

Download
.PDF
Application

Your application will remain active for 30 days. To be considered for a job after 30 days, you must reapply.

Personal Information
First Name	Last Name

Address

City State Zip

Phone	Email

Are you 18 years of age or older? Yes No
Are you legally able to be employed in the US? Yes No
Have you ever worked for The Buckeye Corner before? Yes No

Employment Desired
Locations:	Sawmill Road Lane Avenue Polaris Easton Warehouse Catalog/Internet Sales Corporate Office
Desired Posotion:	Part-Time Full-Time Temporary/Seasonal Second Job
Date You Can Start	Desired Salary

How Many Hours Per Week Do You Prefer To Work?

Availability Please list the hours you are available to work each day.
	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
From
To

Employment History Please list below your last three employers beginning with your most recent.
Company Name	Date Employed	Address
	From To
Your Title	Supervisors Name	Phone Number

Reason For Leaving	Wage Rate
	Full-Time Part-Time
Company Name	Date Employed	Address
	From To
Your Title	Supervisors Name	Phone Number

Reason For Leaving	Wage Rate
	Full-Time Part-Time
Company Name	Date Employed	Address
	From To
Your Title	Supervisors Name	Phone Number

Reason For Leaving	Wage Rate
	Full-Time Part-Time

Professional References Please provide contact information requested below for three businesses and professional references (current and previous employers, supervisors, teachers, professors, etc.). Do no include any relatives.
Name	Phone	Business	Relationship

United States Military Service
Branch of Service	Highest Rank Attained	Date Entered	Date Discharged

Please list any service-related skills or experience applicable to civilian employment.

Education
	Name and Location of School	No of Yrs Attended	Field of Study	Did You Graduate	Diploma or Degree Earned
High School				Yes No
College				Yes No
Trade, Business or Other School				Yes No

Have you ever been convicted of, pled guitly to, or pled no contest to a felony? *
Yes No
If yes describe in full

Have you been convicted of, pled guilty to, or pled no contest to a misdemeanor which resulted in imprisonment during the last two years? *
Yes No
If yes describe in full

* Answering yes will not necessarily disqualify you from employment. Each situation will be judged on its own merits with respect to the time of occurrence, circumstances, and seriousness.

I certify that I have read this Application for Employment and the information I have provided is complete and accurate. I understand that any false statements, misstatements, misrepresentations, or omissions of information are sufficient grounds for immediate termination. I hereby authorize full investigation of all statements contained herein and give HLS ONE, LLC (doing business as The Buckeye Corner), its employees, and agents permission to contact the persons, employers, references, schools, and organizations I have provided to give any and all information concerning my previous employment and/or any other pertinent information they may have. I release all parties from any and all liability for any damage that may result from furnishing information to HLS ONE, LLC (doing business as The Buckeye Corner), its employees, and agents.

I understand and agree that, if hired, my employment is “at will” for no definite period and may be terminated at any time without prior notice and without cause.

Signature

Date

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