BIG R STORES of Illinois & Indiana
Application for Employment
Federal law obligates us to provide reasonable accommodation to the known disabilities of applicants and employees, unless to do so would pose an undue hardship. Please let us know if you need an accommodation to complete the application process or to perform any essential elements of the position sought. Application good for 60 days. All questions must be fully answered before the Company will consider your application. State the facts. Employees may be terminated after hiring for misrepresentation on this application.
Big R is an equal opportunity employer*
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Referred By |
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18 or |
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Position Applied For |
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Over ? |
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If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance with the Immigration Reform and Control Act of 1986. While you need not provide this proof of citizenship or immigration status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired.
Applicant is not obligated to disclose sealed or expunged records of conviction. (Answering yes to the following question does not automatically disqualify you for employment; however, the severity, recency, and relevence of the offense will be considered in the employment review process). Convicted means you were declared guilty by a judge or you pleded guilty or no contest in court. A conviction could have been for either a misdemeanor or a felony. A minor traffic violation is an infraction for which you could be ticketed. Driving while under the influence, driving on a suspended license, reckless driving, leaving the scean of an accident and vehicular homicides are not minor violations. If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance with the Immigration Reform and Control Act of 1986. While you need not provide this proof of citizenship or immigration status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired.
Have you ever been convicted of a crime for anything other than a minor traffic violation?
Are you prevented from lawfully becoming employed in this country?
PREVIOUS WORK EXPERIENCE
Give employment record as completely as possible, starting with your present or last employer. Attach an additional sheet if necessary. Exclude names which indicate, for example, race, color, religion, sex, disability or national origin. For any unemployed or self-employed periods, show dates and locations.
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Job Title |
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Supervisor |
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Reason for leaving |
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Office Use Only |
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Information Verified: Yes No |
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Job Title |
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Supervisor |
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Reason for leaving |
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Office Use Only |
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Information Verified: Yes No |
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Supervisor |
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Office Use Only |
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Information Verified: Yes No |
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Supervisor |
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Reason for leaving |
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Office Use Only |
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Information Verified: Yes No |
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High School Name/Location
Course of Study
Years Attended
Diploma / Degree Received
High School Name/Location
Diploma / Degree Received
High School Name/Location
Diploma / Degree Received
High School Name/Location
Diploma / Degree Received
APPLICANT'S STATEMENT
>These answers are true and complete to the best of my knowledge. The Company may investigate all statements contained in this application, and I understand that any false or misleading information provided may result in my immediate discharge.
>I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT AND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN MYSELF AND THE COMPANY IS TERMINABLE-AT-WILL. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.
>I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor selected by the Company, to determine whether I can perform the job duties. In addition, I understand a drug test will be required. I also understand that if I am employed by the Company, I may be required to submit to lawful searches of my property or person in certain instances.
>I authorize the Company to make a thorough investigation of my past employment education and job-related activities and I release from all liability all persons, companies, and corporations supplying such information. I also indemnify this Company against any liability which might result from making such investigation.
>Additionally, I authorize the Company to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that the Company deems appropriate.
Do you have any special experience, skills, or education that might be useful while employed at Big R Stores?
References: Do not include family or employers
Name
Address
Phone
Office Use Only
Information Verified: Yes No
References: Do not include family or employers
Name
Address
Phone
Office Use Only
Information Verified: Yes No
Please print this document and sign.
Take to service desk at local Big R Store
*It is the policy of this company to provide equal employment opportunity to all employees and applicants for employment without regard to race, color, religion, sex, national origin, handicap, age, ancestry, marital status, unfavorable military discharge, veterans status, citizenship status, or any other status entitled to protection under state or federal law, and to make employment decisions consistent with this principle of equal employment opportunity. To this end, this company affirmatively seeks to employ and advance for employment, qualified disabled veterans, veterans of the Vietnam era and conducts all employment activities, including but not limited to, hiring, promotion, demotion, transfer, recruitment, advertising, layoff, discharge, rates of pay, and selection for training without regard to race, color, religion, sex, age, ancestry, marital status, unfavorable military discharge, or national origin, citizenship status or any other status entitled to protection under State or Federal law.