Name:
Street Address:
City:
State: / Zip: / Phone (Cell/Home):
Phone Numbers (Cell)/(Home):
Email:
Social Security Number: / Date of Birth:
Are You a US Citizen: / If No, Green Card/Permit #:
In Case of Emergency Contact Name:
Contact Phone Number(s):
Medical Conditions We Need to Be Aware of In Emergency Situation:
Have you ever been convicted of a felony: ⃝ Yes ⃝No? If Yes, explain in notes below.
Are you legally eligible for hire (documentation required) for hire in the US? (Legal Resident, Naturalized Citizen, Visa) ⃝ Yes ⃝No?
Were you referred here by an employee, family, or friend? / ⃝ Yes ⃝No? If Yes, who:
Computer Software, Special Skills, Trades, Knowledge:
Are you currently Employed? / ⃝ Yes ⃝No?
Working hours are Monday through Friday between 8 and 6 and Sundays for part of the year. Is there any days or hours you cannot work or need schedule accommodations for? Please Explain:
Date you can begin working: / Expected Starting Pay:
What job position(s)garm are you interested in:
⃝ Sales & Technical Support ⃝ Shipping Dept. ⃝ Graphic/Website
⃝ Prep/Workroom/General Support ⃝ Customer Service/Admin Support
Please list all jobs, beginning with your present or last employer. Account for all time periods, including unemployment, self-employment, and US Military Service
Company Name: / Company Address:
Phone #: / Supervisor:
State Date: / End Date: / Total Time Worked:
Start Salary: / End Salary:
May we contact your supervisor/employer:
Responsibilities/Job Duties:
Type of Business:
Reason for Leaving: ⃝ Quit ⃝ Retired ⃝ Discharged ⃝ Return to School
⃝ Better Opportunity
Are you eligible for hire with that company:
Company Name: / Company Address:
Phone #: / Supervisor:
State Date: / End Date: / Total Time Worked:
Start Salary: / End Salary:
May we contact your supervisor/employer:
Responsibilities/Job Duties:
Type of Business:
Reason for Leaving: ⃝ Quit ⃝ Retired ⃝ Discharged ⃝ Return to School
⃝ Better Opportunity
Are you eligible for hire with that company:
Company Name: / Company Address:
Phone #: / Supervisor:
State Date: / End Date: / Total Time Worked:
Start Salary: / End Salary:
May we contact your supervisor/employer:
Responsibilities/Job Duties:
Type of Business:
Reason for Leaving: ⃝ Quit ⃝ Retired ⃝ Discharged ⃝ Return to School
⃝ Better Opportunity
Are you eligible for hire with that company:
Note from Applicant:
Outdoor Supply Notes:
Signing below, I am affirming that all the information I have provided on my application is accurate and truthful.
Applicant SignatureDate
Applicant Printed Name
Background Check Agreement
By signing below you are giving Outdoor Supply Inc. permission to obtain a background check, which is something we request with new hires. Your information will NOT be shared with other employees or outside sources. We appreciate your cooperation.
Applicant SignatureDate
Applicant Printed Name