GAP INC. GAP BANANA REPUBLIC OLD NAVY An Equal Opportunity Employer EMPLOYMENT INFORMATION General Information. Please complete all requested information. Use ink and print. Location/Store # Name (Last) (First) Today’s Date Position Desired (Middle) Minimum Salary Desired Email Address I am interested in: Full-time 30 – 40 hrs. per week Street Address Date Available For Work Part-time 0 –29 hrs. per week Are you at least 18 years old? Are you at least 16 years old? City State Zip Telephone (Home) Telephone (Cell) Yes Yes Seasonal Holiday/Summer No If you are under 18, you may be required No to provide a work permit prior to working. Please indicate the hours you are available to work during both day and evening (i.e., 2– 4 p.m., 6 –10 p.m.) S M T W S F TH Note: Should your availability change, it is your responsibility to notify your supervisor If you have worked for our company before (Gap, Banana Republic, Old Navy, Outlet, Factory Stores), state where, when, final position, and reason for leaving. Do you have any relatives now employed by our company? Yes If yes, identify by name(s), position and location: Have you ever applied to our company before? If yes, where? Work Experience. List your previous experience, beginning with your current or most recent position. Employer Street Address Phone City Supervisor State Zip Name/Title Most Recent Position Most Recent Salary Dates of Employment Start: Month Employer Street Address City Supervisor State Zip Name/Title Employer City Supervisor State Name/Title Reason For Leaving End: Month Year Starting Position Starting Salary Most Recent Position Most Recent Salary Dates of Employment Start: Month Street Address Year Duties Reason For Leaving Phone Starting Salary Duties Reason For Leaving Phone Starting Position Zip Year End: Month Year Starting Position Starting Salary Most Recent Position Most Recent Salary Duties Dates of Employment Start: Month Year End: Month Year References. Individuals not related to you. Business references preferred. Reference Phone Street Address Email Job Title Reference Phone Job Title Reference Phone Job Title City State How Acquainted and For How Long Street Address Email State How Acquainted and For How Long Street Address Email City City How Acquainted and For How Long State No Education & Training: Please include name, street, city, state and zip code for each school. School Address (include city & state) Number of Years Completed Degree Type of Course/Major College High School Additional Training Foreign languages? Spoken Fluently? For office positions, indicate the job skills which you have performed: n Typing _________WPM n 10-key By Touch By Sight (Circle One) Computer/Software Other Additional Employment History Inquiries n Yes Have you ever been dismissed or forced to resign from any employment? n No If yes, please explain: n Yes n No Have you been convicted of a felony crime or theft-related misdemeanor within the last 7 years that has not been expunged, sealed, impounded or annulled? (In California only: Do not answer yes if you were referred to or participated in a diversion program, or if your conviction was solely for a marijuana-related offense more than 2 years old.) If yes, state details: Convictions will not necessarily disqualify applicant; each case is considered individually. Permission to Work Are you legally authorized to work in the United States? n Yes n No Will you now or in the future require sponsorship for employment visa status (e.g., H1-B status)? n Yes n No Referral Source n Walk-in Applicant n Newspaper Ad n Employee Referral (Name) __________________________________________________________ n Community Organization (Name) _________________________________________ n School/College ___________________________________ n Website (Name) ______________________ n Other (Please List) _________________________________________________________________ Additional Questions Why are you interested in working for our company? What strengths would you bring to our company? What didn’t you like about your previous jobs? NOTICE TO APPLICANTS IN MARYLAND: UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND THAT AN INDIVIDUAL TAKE A LIE DETECTOR OR SIMILAR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100. NOTICE TO APPLICANTS IN MASSACHUSETTS: IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITY. Applicant’s Statement If I am employed, I agree to abide by the rules and regulations of the Company. I understand that my employment is at-will. This means that I do not have a contract of employment for any particular duration or limiting the grounds for my termination in any way. I am free to resign at any time. Similarly, Gap Inc. is free to terminate my employment at any time for any reason. I understand that while personnel policies, programs and procedures may exist and be changed from time to time, the only time my at-will status could be changed is if I were to enter into an express written contract with Gap Inc. explicitly promising me job security, containing the words “this is an express contract of employment” and signed by an officer of Gap Inc. The above language contains our entire agreement about my at-will status and supercedes any past, future, or oral side agreements. All of the information I have supplied in this application is a true and complete statement of the facts, and if employed, any false statement or omission could result in immediate dismissal. I understand that Gap may share the information contained in this application with other Gap employees for employment and administrative purposes and hereby consent to such transfer. I authorize you to contact my references, as well as current and previous employers, to obtain information on my work history and qualifications for employment. Signature Date This application will only be considered for three months. If you have not been hired within three months of filling out this application and you wish to continue to be considered for employment, you must fill out another application.
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