The Buckeye Corner

Employment Application

The Buckeye Corner is always interested in talking to passionate, self-motivated and customer focused individuals for all levels of our company. We provide a growing and fast-paced work environment where new ideas and creativity are always welcome

Please enter your personal information below to be considered for employment opportunities with our company.

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
Do you have any friends or relatives who work for The Buckeye Corner? Yes No
How did you find out about employment opportunities at The Buckeye Corner?

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

How Many Hours Per Week Do You Prefer To Work?
Upload Your Resume: Resume must be in Word Document, or PDF Format.

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
May we contact this employer? Yes No
Company Name	Date Employed	Address
	From To
Your Title	Supervisors Name	Phone Number

Reason For Leaving	Wage Rate
	Full-Time Part-Time
May we contact this employer? Yes No
Company Name	Date Employed	Address
	From To
Your Title	Supervisors Name	Phone Number

Reason For Leaving	Wage Rate
	Full-Time Part-Time
May we contact this employer? Yes No

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 a felony, misdemeanor or crime of any kind?^* For purposes of this question, a conviction includes a plea, verdict or finding of guilt regardless of whether a sentence was imposed. You may exclude information regarding any conviction for which the record has been judicially ordered sealed, expunged, or statutorily eradicated. Yes No

If yes describe in full

^* Convictions will not necessarily disqualify an applicant from employment

Please read carefully before signing

This is an equal opportunity employere. I understand that no question being asked as part of my consideration for employment is intended to be unlawful. Although management makes every effort to accomodate individual preferences, business needs may at times make the following conditions mandatory: overtime, change in work location, a rotating work schedule, or a work schedule other than Monday through Friday. If employed, I understand and accept these conditions of my continuing employment. Additionally, I am aware that my employment is contingent on operational requirements.

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, employeres, 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


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

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