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BHC- Employment Application
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* Indicates required question
Name (First Middle Last)
*
Your answer
Current Address including City, State, Zip
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Are you legally eligible to work in the US?
*
Yes
No
Are you a veteran?
Yes
No
Clear selection
If selected for employment, are you willing to submit to a background check?
*
Yes
No
What position are you applying for?
*
Cashier
Sales Associate
Other:
Available start date:
*
MM
/
DD
/
YYYY
Desired pay:
*
Your answer
Employment desired:
*
Full Time >30 hours per week
Part Time <30 hours per week
Seasonal/ Temporary
Describe your ideal work schedule:
*
Your answer
Most Recent Education -School Name/ Location/ Years Attended/ Degree Received/ Major
*
Your answer
Reference 1 (Business & Professional only) Name/ Phone Number
*
Your answer
Reference 2 (Business & Professional only) Name/ Phone Number
*
Your answer
Reference 3 (Business & Professional only) Name/ Phone Number
*
Your answer
Please provide a brief description of your employment history.
*
Your answer
Do you have transportation or would you be able to arrange for transportation?
*
Yes
No
Is there anything else you would like to share for the interview team to consider?
Your answer
Electronic Signature- I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated. (Type your name and the date)
*
Your answer
Submit
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