Hanover Direct, Inc.: Jobs

EMPLOYMENT APPLICATION

PERSONAL

E-MAIL ADDRESS:
DATE OF APPLICATION:

FIRST NAME:		MIDDLE INITIAL:
LAST NAME:

PRESENT ADDRESS:
STREET 1:
STREET 2:

CITY:

STATE:

ZIP:

PREVIOUS ADDRESS:
STREET 1:
STREET 2:

CITY:

STATE:

ZIP:

RESIDENCE PHONE:

MOBILE PHONE:

DO YOU HAVE THE LEGAL RIGHT TO LIVE AND WORK IN THE UNITED STATES?

YES

HAVE YOU EVER APPLIED TO THE COMPANY BEFORE?

YES

IF YES, WHEN:

WHERE:

HAVE YOU EVER BEEN EMPLOYED BY THE COMPANY?

YES

IF YES, WHEN:

WHERE:

ARE YOU ON LAY-OFF STATUS AND SUBJECT TO RECALL?

YES

ARE YOU RELATED TO ANYONE CURRENTLY EMPLOYED BY THE COMPANY?

YES

PLEASE IDENTIFY:

IF YOU ARE UNDER 18 YEARS OF AGE, CAN YOU PROVIDE PROOF OF YOUR ELIGIBILITY TO WORK?

N/A

YES

WORK PREFERENCE

WHAT TYPE OF POSITION ARE YOU SEEKING?

DATE AVAILABLE:

DESIRED SALARY

PRESENT OR MOST RECENT SALARY:

ARE YOU WILLING TO TRAVEL? YES NO

ARE YOU WILLING TO RELOCATE? YES NO

WHAT DAYS AND HOURS ARE YOU AVAILABLE?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

From

To

SHIFT PREFERENCE? DAY EVENING LATE NIGHT

TYPE OF EMPLOYMENT DESIRED:

REGULAR: FULL TIME PART TIME
TEMPORARY: FULL TIME PART TIME LENGTH OF TIME

DO YOU READ OR SPEAK ANY FOREIGN LANGUAGES? YES NO

IF YES, WHAT LANGUAGE:

NOTE: DO NOT ANSWER THE FOLLOWING OUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING:

CAN YOU PERFORM THE ESSENTIAL FUNCTIONS OF THIS JOB, WITH OR WITHOUT REASONABLE ACCOMMODATIONS? YES NO

EDUCATION

DO YOU HAVE A GED? YES NO

DID YOU GRADUATE? GPA ACADEMIC YEARS OR CREDITS COMPLETED DEGREE RECEIVED OR EXPECTED MAJOR SUBJECT

HIGH SCHOOL

COLLEGE

GRADUATE

TECHNICAL 0R VOCATIONAL

PROFESSIONAL CERTIFICATIONS

SPECIALIZED SKILLS

SOFTWARE:
(PLEASE LIST)

TYPING (WPM)

PRODUCTION/
MOBILE MACHINERY
(LIST):

OTHER:

EMPLOYMENT DATA

LIST MOST RECENT EMPLOYER FIRST. COVER THE ENTIRE PERIOD OF YOUR PROFESSIONAL CAREER.

1 2 3

NAME OF EMPLOYER:

TITLE OF LAST POSITION:

PHONE:

STREET:

CITY AND STATE:

SALARY UPON LEAVING:

ACTUAL DUTIES:

NAME AND TITLE OF IMMEDIATE SUPERVISOR:

REASON FOR LEAVING:

DATES
EMPLOYED:

From To

From To

From To

MAY WE CONTACT THIS EMPLOYER FOR A RECOMMENDATION?

ADDITIONAL INFORMATION:

FELONY CONVICTION

HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO

IF YES, WHEN: WHERE: DISPOSITION:

* A CONVICTION WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT. FACTORS SUCH AS THE TIME OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION AND REHABILITATION WILL BE CONSIDERED.

REFERRAL SOURCE (PLEASE IDENTIFY):

PROFESSIONAL REFERENCES (EMPLOYMENT ONLY)

1 2

NAME:

JOB TITLE & RELATIONSHIP:

STREET:

CITY AND STATE:

TELEPHONE:

MILITARY LIST ALL UNITED STATES SERVICE

BRANCH:

HIGHEST RANK:

	From	To
DATES OF SERVICE:

I HEREBY AUTHORIZE HANOVER DIRECT, INC TO SOLICIT INFORMATION FROM ALL REFERENCES AND EMPLOYERS UNLESS OTHERWISE INDICATED ON THIS APPLICATION.  I UNDERSTAND THAT AS PART OF THIS APPLICATION I WILL BE REQUIRED TO SIGN A NOTICE THAT, UPON AN OFFER OF CON EMPLOYMENT, AUTHORIZES THE COMPANY TO OBTAIN INVESTIGATIVE CONSUMER REPORTS WHICH MAY INCLUDE INFORMATION MY CREDIT HISTORY, WORK HISTORY, PERSONAL BACKGROUND, CRIMINAL RECORDS, AND OTHER MATTERS.  I UNDERSTAND THAT ANY OFFER OF EMPLOYMENT IS CONTINGENT UPON THE RESULTS OF REFERENCE AND BACKGROUND REVIEWS, AND THAT ANY OMISSIONS AND MISREPRESENTATIONS OF ANY INFORMATION ON THIS APPLICATION AND ATTACHMENTS MAY RESULT IN REFUSAL OF OR SEPARATION FROM EMPLOYMENT.

I UNDERSTAND THAT IN THE EVENT I AM OFFERED EMPLOYMENT WITH HANOVER DIRECT, INC.  I MAY HAVE TO UNDERGO A DRUG TEST AT NO COST OR OBLIGATION TO ME BY A LABORATORY FACILITY RETAINED BY HANOVER DIRECT, INC.  I HEREBY AGREE THAT TAKING THIS DRUG TEST IS VOLUNTARY ON MY PART.  I FURTHER UNDERSTAND AND AGREE THAT SHOULD THE RESULTS OF SAID TEST PROVE POSITIVE, THE OFFER OF EMPLOYMENT MAY BE RESCINDED.  NOTWITHSTANDING THE ABOVE, I HEREBY AGREE TO SUBMIT TO SAID DRUG TEST VOLUNTARILY AND OF MY OWN FREE WILL.

I UNDERSTAND THAT, IF HIRED, EITHER I OR HANOVER DIRECT, INC.  MAY TERMINATE MY EMPLOYMENT AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.  I UNDERSTAND THAT, WITH THE EXCEPTION OF THE CEO OR ITS DESIGNEE, NO MANAGER OR REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME.  I FURTHER UNDERSTAND THAT THIS STATEMENT SUPERCEDES ANY PRIOR ORAL OR WRITTEN UNDERSTANDING AND BARS ANY FUTURE ORAL UNDERSTANDING TO THE CONTRARY.

I UNDERSTAND THAT THIS APPLICATION FOR EMPLOYMENT WITH HANOVER DIRECT, INC.  WILL REMAIN ACTIVE FOR A PERIOD OF NINETY DAYS FROM THE DATE ON WHICH IT WAS SIGNED BY ME.  AFTER THIS NINETY-DAY PERIOD, I UNDERSTAND THAT IF I WISH TO BE CONSIDERED FOR AN OPEN POSITION I MUST SUBMIT A NEW APPLICATION FOR EMPLOYMENT.

IT IS THE POLICY OF HANOVER DIRECT, INC.  TO SEEK AND EMPLOY THE BEST QUALIFIED PERSONNEL AND TO PROVIDE EQUAL OPPORTUNITY FOR THE ADVANCEMENT OF EMPLOYEES AND TO ADMINISTER THESE ACTIVITIES IN A MANNER WHICH WILL NOT DISCRIMINATE AGAINST ANY PERSON BECAUSE OF RACE, COLOR, GENDER, RELIGION, NATIONAL ORIGIN, ANCESTRY, DISABILITY, AGE OR OTHER STATUS PROTECTED BY FEDERAL, STATE OR LOCAL LAW.

SIGNATURE: (PLEASE INITIAL HERE) DATE:

Please submit to :

SIGNATURE: (PLEASE INITIAL HERE)		DATE:
Please submit to :