Fillable Printable Target World Employment Application Form
Fillable Printable Target World Employment Application Form
Target World Employment Application Form
Target World Employment Application Form
Instructions: Print clearly in black or blue ink. Answer all questions. Sign and date the form. Either bring the form in to
Target World or mail it to us at:
Target World
2300 East Kemper Road
Cincinnati, OH 45244
APPLICANT INFORMATION:
Applicant Name ______________________ _________________
Home Phone _________________________________________
Other _______________________________________________
Email Address ___ _____________________ ________________
Current Address:
Number and street ________________________________ ____
City ________________________________________ ________
State & Zip ______________________________________ ____
Social Security #______________________ ________________
How were you referred to Target World?:_____________ _______________________________ ___________
POSITION/AVAILABILITY:
Position(s) applying for:_ ____________ _______________________________ _
Are you applying for:
•Regular part-time work? [ ] Y or [ ] N
•Regular full-time work? [ ] Y or [ ] N
What days and hours are you available for work?_______________________ ____________________________
If applying for temporary work, when will you be available? _____________________________________ ______
If hired, on what date can you start working? ___ / ___ / ___
Can you work on the weekends? [ ] Y or [ ] N
Can you work evenings? [ ] Y or [ ] N
Are there any hours, shifts or days you cannot or will not work? ____ ____________________________________
Are you available to work overtime? [ ] Y or [ ] N
Salary desired: $_____________ ___________________
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PERSONAL INFORMATION:
Have you ever applied to / worked for Company before? [ ] Y or [ ] N
If yes, please explain (include date): ___ _____________________ ________________
Do you have an y friends, rela tives, or acquaintances working for Compan y? [ ] Y or [ ] N
If yes, state name & relationship: ___________________________________ ________
If hired, would you have transportation to/from work? [ ] Y or [ ] N
If hired, are you willin g to submit to and pass a controlled substance test? [ ] Y or [ ] N
Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable
accommodation? [ ] Y or [ ] N
If no, describe the functions that cannot be performed:
___________________________________
________________________________________________________________________
(Note: Company comp lies with the ADA and consider reasonable accommodation measures that may be necessary
for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility
and may be subject to a medical examination cond ucted by a medical prof essional.)
Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ] N
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, includ ing any significant details that affect the desc ription of the event, and the
surrounding cir cumstances and the relevance of the offense to the position(s) app lied for may, however, be
considered.)
EDUCATION:
High School:
School name: ____________ __________________________
School city, state:______________________ _____________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _________________
College / University #1:
School name: ____________ __________________________
School city, state:______________________ _____________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _________________
College / University #2:
School name: ____________ __________________________
School city, state:______________________ _____________
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Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _________________
Vocational School:
School name: ____________ __________________________
School city, state:______________________ _____________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _________________
SPECIAL SKILLS AND QUALIFICATIONS: List job-related licenses, skills, training, honors, awards, and special
accomplishments.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
EMPLOYMENT HISTORY:
Are you currently employed? [ ] Y or [ ] N
If you are currently employed, may we contact your current employer? [ ] Y or [ ] N
Below, please describe past and present employment positions, datin g back five years. Please account for all periods
of unemployment. E ven if you have attached a resume, this section mu st b e completed.
Name of Employer:____ _____________________ _____________
Name of Supervisor:______________________ ______________
Telephone Number:______________________________________
Business Type:[ ________________________
Address:________________________
City, state, zip:____________ ____________________
Length of Employment (Include Dates): _____________________
Position & Duties:___________________________________________ ____________
Reason for Leaving: ___________ _______________________________ ___________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:____ _____________________ _____________
Name of Supervisor:______________________ ______________
Telephone Number:______________________________________
Business Type: ___________ _____________
Address:________________________
City, state, zip:____________ ____________________
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Length of Employment (Include Dates): _____________________
Position & Duties:___________________________________________ ____________
Reason for Leaving: ___________ _______________________________ ___________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:____ _____________________ _____________
Name of Supervisor:______________________ ______________
Telephone Number:______________________________________
Business Type: ___________ _____________
Address:________________________
City, state, zip:____________ ____________________
Length of Employment (Include Dates): _____________________
Position & Duties:___________________________________________ ____________
Reason for Leaving: ___________ _______________________________ ___________________
May we contact this employer for references? [ ] Y or [ ] N
Military:
Branch: _____________________________________
Rank At Discharge:_______________________________
Total Years of Service: ________
Skills/duties: _____________________________________________ ______________________________
Related details:_________ ______________________ __________________________________________
REFERENCES:
List below three persons who have knowledge of your work performance within the last four years.
Please includ e professional references only.
Name - First, Last: ____________________________ __________
Telephone Number:_____________________________________
Address:______________________________________________
City, state, zip:____________ ______________________________
Occupation: ____________________________________________
Number of Years Acquai nted: ______________________________
Name - First, Last: ____________________________ __________
Telephone Number:_____________________________________
Address:______________________________________________
City, state, zip:____________ ______________________________
Occupation: ____________________________________________
Number of Years Acquai nted: ______________________________
Name - First, Last: ____________________________ __________
Telephone Number:_____________________________________
Address:______________________________________________
City, state, zip:____________ ______________________________
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Occupation: ____________________________________________
Number of Years Acquai nted: ______________________________
Please Read and Initial Each Paragr aph, then Sign Below
I certify that I have not purposely withheld any information that might adversel y affect m y 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 (i ncluding any m isstatement) 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.
_____
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 compan y.
_____
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 suc h disclosure. In addition, I release the
company, my former employers & all other persons, corpor ations, partnerships & associations from any & all claims,
demands or liabilities arising out of or in any way related to such examination or revelation.
_____
Applicant's Signature:___ __________ _________________
Date:_________________________________
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