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Mineralogy Employment Application
Please answer all of the following to the best of your ability. Feel free to contact us at
info@shopmineralogy.com
with questions.
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* Indicates required question
Full Name
*
Your answer
Full Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Are you 18 or older?
*
Yes
No
Which gallery are you applying for? (Select All That Apply)
*
Crabtree Valley Mall - Central Raleigh, NC
The Streets at Southpoint - Durham, NC
Required
Are you legally eligible to work in the US?
*
Yes
No
Are you a veteran?
*
Yes
No
What position are you applying for?
*
Your answer
Available Start Date
*
MM
/
DD
/
YYYY
Desired Pay
*
Your answer
Employment Desired
*
Full Time
Part Time
Seasonal/Temporary
Required
Why would you like to work with us? Why would you be good addition to the Mineralogy team?
*
Your answer
Formal Education 1 (Please Provide Name, Location, Years Attended, and Degrees Earned)
Your answer
Formal Education 2 (Please Provide Name, Location, Years Attended, and Degrees Earned)
Your answer
Formal Education 3 (Please Provide Name, Location, Years Attended, and Degrees Earned)
Your answer
Reference 1 (Please Provide Name, Title, Company, and Phone Number or Email Address)
Your answer
Reference 2 (Please Provide Name, Title, Company, and Phone Number or Email Address)
Your answer
Reference 3 (Please Provide Name, Title, Company, and Phone Number or Email Address)
Your answer
Employment History 1 (Please Provide Employer, Job Title, Length of Employment, Pay Rate, and Phone Number)
Your answer
Employment History 2 (Please Provide Employer, Job Title, Length of Employment, Pay Rate, and Phone Number)
Your answer
Employment History 3 (Please Provide Employer, Job Title, Length of Employment, Pay Rate, and Phone Number)
Your answer
Employment History 4 (Please Provide Employer, Job Title, Length of Employment, Pay Rate, and Phone Number)
Your answer
Employment History 5 (Please Provide Employer, Job Title, Length of Employment, Pay Rate, and Phone Number)
Your answer
SIGNATURE DISCLAIMER. I certify that my answers are true and complete to the best of my knowledge. lf 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 FULL NAME BELOW)
*
Your answer
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