ONLINE EMPLOYEE APPLICATION

Please complete the Application form below. Fields marked with an asterisk (*) are required.

Position applied for:*
Store AssociateAssistant ManagerCleanroom TechnicianWarehouse Staff

Location Applied For:*
68th StreetAlpineBenton HarborCorporate OfficeFullerGrandvilleGrand HavenHastingsHollandLowellStandaleWarehouseWest River Drive

First Name:*

Last Name:*

Date of Birth:*
JanFebMarAprMayJunJulAugSepOctNovDec
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202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940

Telephone:*

Email (Optional):

Address:



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How long have you lived at this address?*

Do you have reliable transportation?*
YesNo

If under the age of 18, can you produce the necessary work certificate at the time of employment?*
YesNo

Type of employment desired:*
Part-TimeFull-Time

Desired number of hours per week:*

Desired Salary/Hourly Rate:*

Are you willing to work overtime?*
YesNo

Have you previously applied for employment with this company?*
YesNo

If yes, when and where did you apply?

Have you ever been employed by this company?
YesNo

If yes, provide dates of employment, location, and reason for leaving employment:*

Please attach a copy of your resume with education, work history, and references.