1. MAIN STREET PET SUPPLY
      1. Employment Application
    MAIN STREET PET SUPPLY



    Employment Application

    NOTICE TO APPLICANT: We are an Equal Opportunity Employer and do not discriminate on the basis of race, color, religion, sex, sexual orientation, national origin, citizenship, age, physical or mental disability, or any other characteristics. You are not required to furnish any information that is prohibited by federal, state, or local law. Offers of employment may be contingent upon applicant passing a drug test.

     

    INSTRUCTIONS: We appreciate your interest in working for Main Street Pet Supply and are interested in your qualifications. A clear understanding of your background and work history will aid us in evaluating your qualifications and in considering your application. Please answer all questions fully and accurately. Completed applications can be dropped off at the store between 12pm and 3 pm every day, or email the completed application to jobs@mainstreetpetsupply.com.

     

    APPLICANT INFORMATION
    Last Name Ishibashi First Hannah M.I. Date 05/07/2012
    Street Address 1300 19th Avenue Apartment/Unit #   
    City San Francisco State CA ZIP 94122
    Phone (415) 555-1234 E-mail Address hannahishibashi@gmail.com
    Date Available immediately Social Security No. 555-66-7891 Desired Salary $9.92 an hour   
    Position Applied for Sales associate
    Are you a citizen of the United States? YES ☑

          		NO ☐

          		If no, are you authorized to work in the U.S.? YES ☑

          		NO ☐
    Have you ever worked for this company? YES ☐ NO ☑ If so, when?  
    Have you ever been convicted of a felony? YES ☐ NO ☑ If yes, explain  
    Are there hours or days you are unwilling or unable to work?*

    *Please note: we are generally unable to consider candidates who are unavailable on evenings or weekends.

          		YES ☑

          		NO ☐ If yes, explain I can work any hours once school gets out in June. Before that, I would need to work evenings or weekends.
     
    EDUCATION
    High School Thurgood Marshall H.S. Address 45 Conklin St, San Francisco, CA 94124
    From 08/10 To present Did you graduate? YES ☐ NO ☑ Degree Expected diploma in 2014
    College n/a Address   
    From  To  Did you graduate? YES ☐ NO ☐ Degree   
    Other n/a Address   
    From  To  Did you graduate? YES ☐ NO ☐ Degree   
     
    REFERENCES
    Please list three professional references.
    Full Name Mr. Prashant Desai Relationship history teacher
    Company Thurgood Marshall H.S. Phone ( 415 ) 222-3456
    Address’

           		123 Home Street, San Francisco, CA, 12345
    Full Name Ms. Artemis Bliss Relationship Babysitting client
    Company n/a Phone ( 415 ) 333-1234
    Address 1303 19th Avenue, San Francisco, CA 94122
    Full Name Mrs. Kyoko Nishimura Relationship Volunteer supervisor
    Company Kimochi, Inc. Phone ( 415 ) 444-5678
    Address N/A   
    PREVIOUS EMPLOYMENT
    Company n/a Phone ( 415 ) 333-1234
    Address 1303 19th Ave SF CA 94122 Supervisor Artemis Bliss   
    Job Title Babysitter Starting Salary $ 10/hour Ending Salary $ 10/hour
    Responsibilities Supervise three children at once ages 5, 7, and 9      
    From 2010  To present  Reason for Leaving Haven’t left. I babysit regularly
    May we contact your previous supervisor for a reference? YES ☑ NO ☐   
    Company  Phone ( )
    Address  Supervisor   
    Job Title  Starting Salary $ Ending Salary $
    Responsibilities   
    From  To  Reason for Leaving   
    May we contact your previous supervisor for a reference? YES ☐ NO ☐   
    Company  Phone ( )
    Address  Supervisor   
    Job Title  Starting Salary $ Ending Salary $
    Responsibilities   
    From  To  Reason for Leaving   
    May we contact your previous supervisor for a reference? YES ☐ NO ☐   
     

     

     

       
    KNOWLEDGE AND SKILLS
    DOGS A little ☑ Some ☐ A lot ☐ Please explain: My neighbor has a dog and I’ve t aken care of it a few times.
    CATS A little ☐ Some ☐ A lot ☑ Please explain: I’ve had cats for 10 years and I do almost everything to take care of them.
    FISH  A little ☐ Some ☑ A lot ☐ Please explain: I had a goldfish for three years until it died.
    BIRDS   A little ☐ Some ☐ A lot ☐ Please explain:
    SMALL

    MAMMALS     		A little ☐ Some ☑ A lot ☐ Please explain:   I help my little sister take care of her hamster; she’s six so she needs a lot of supervision with it.
    REPTILES A little ☐ Some ☐ A lot ☐ Please explain:
    OTHER A little ☐ Some ☐ A lot ☐ Please explain:   
    USING WINDOWS A little ☐ Some ☐ A lot ☑ Please explain: My computer at home uses Windows and I’ve used Windows at school.
    USING WORD A little ☐ Some ☐ A lot ☑ Please explain:

    I write all my school papers in Word.
    USING EXCEL A little ☑ Some ☐ A lot ☐ Please explain:

    I’ve used it a few times for school.
    USING OUTLOOK A little ☐ Some ☐ A lot ☐ Please explain:   
    OTHER COMPUTER SKILLS A little ☐ Some ☑ A lot ☐ Please explain:

    I’m also comfortable using Macs.
    Please list any activities, memberships, awards, licenses, or accomplishments you feel may be relevant to this position:

     

     

    Perfect Attendance Award (9th Grade)

    Most Improved, Algebra (9th Grade)

     

     

           		 
    DISCLAIMER AND SIGNATURE
    I certify that my answers are true and complete to the best of my knowledge.

    If this application leads to employment, I understand that false or misleading information in my application or interview

    may result in my release.

    Signature Hannah Ishibashi Date May 7, 2012

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