Bike Shop Job Application

Applicant Information

General Information

Application Name:

First and Last Name

Daytime Phone:

Email Address:

Are you over the age of 18?

Yes

No

Birth Date:

Applicants under 18 must provide verification minimum legal working age.

Address:

Street:

City:

State & Zip:

Employment Position:

Position(s) applying for:

Temporary work - such as summer or holiday work?

Yes

No

Full time position?

Yes

No

Days Available:

How many hours per week would you like to work?

When are you available?

Salary Desired?

Background Information

Are you a US citizen?

Yes

No

Must provide acceptable forms of ID when hired.

Have you ever been convicted of a criminal offence (felony or misdemeanor)?

Yes

No

If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case.

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Have you worked in a retail store?

Yes

No

If yes, please explain

Have you been employed in a bicycle shop?

Yes

No

If yes, please explain:

Have you been employed as a mechanic?

Yes

No

If yes, please explain:

Additional Information Relating to Bicycles: (i.e Raced for x team for y years, member of a bicycling club, etc...)

Why are you interested in working in the bicycle industry?

What if any previous knowledge of bicycling do you have?

Employment History

Below, please describe past and present employment positions, dating back five years. Please account for all periods of unemployment. If you have attached a resume, this section may be omitted

Are you currently employed?

Yes

No

Name of Employer:

Name of Supervisor:

Telephone Number:

Business Type:

Business' Address:

City, State, Zip:

Length of Employement: (Include Dates)

Position held:

Duties & Responsibilities

Please list them, separated by a comma.

Reason for leaving?

May we contact your employer?

Yes

No

Name of Employer:

Name of Supervisor:

Telephone Number:

Business Type:

Address:

City, State, Zip:

Length of Employement: (Include Dates)

Position held:

Duties & Responsibilities:

Please list, separating items with a comma.

Reason for leaving?

May we contact your employer?

Yes

No

Name of Employer:

Name of Supervisor:

Telephone Number:

Business' Address:

Address:

City, State, Zip:

Length of Employement: (Include Dates)

Position held:

Duties & Responsibilities:

Reason for leaving?

May we contact your employer?

Yes

No

References

List below three persons who have knowledge of your work performance within the last four years. We prefer professional references.

Name:

First & Last

Telephone Number:

Occupation:

Number of years acquainted:

Name:

First & Last

Telephone Number:

Occupation:

Number of years acquainted:

Name:

First & Last

Telephone Number:

Occupation:

Number of years acquainted:

Please Read and Initial Each Paragraph, then Sign Below

I

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.

II

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.

III

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation

Is all the information you submitted correct to the best of your knowledge?

Yes

No

Applicant's Signature:

type in your name.

Date:

Careers

Applicant Information

Address:

Employment Position:

Background Information

Employment History

References

Please Read and Initial Each Paragraph, then Sign Below

Locations

Shop

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