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EMPLOYMENT APPLICATION - ONLINE
Contact Information
Today's Date:
First Name:
Last Name:
Middle Initial:
Address:
City:
State:
Delaware
District of Columbia
Maryland
New Jersey
New York
Ohio
Pennsylvania
Zip Code:
Email:
Phone Number
(with area code)
Cell Phone
(with area code)
Are you able to legally work in the United States?
Yes
No
Employment Information
Position Desired:
Which Smokin' Joe's Tobacco Shop, Inc. location desired?
Ashland
Beach Lake
Bristol
Choconut
Delmar, DE
Easton
East Stroudsburg
Fassett
Great Bend - Hallstead
Greencastle
Honesdale
Hanover
Lawrenceville
Matamoras
Millerton
Minersville
Montrose
Morrisville - Bridge Street
Morrisville - Trenton Ave
Mount Bethel
Sayre - Elmira
Sayre - Keystone Ave
Sayre - Wilawana
Starlight
Stroudsburg
Tacony
Wellsboro
Wilkes-Barre
Wyalusing
Wysox
Date you can start:
Salary desired:
Are you currently employed?
Yes
No
Is your current job...
Full-time
Part-time
What kind of job are you looking for?
Full-time
Part-time
Have you ever applied to, or worked for, Smokin' Joe's Tobacco Shop, Inc. before?
Yes
No
If YES, when and where:
Education, Training and Skills Information
High School Attended:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Did you graduate?
Yes
No
Still Attending
GED
College or Trade School:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Degree:
Major Studied:
Did you graduate?
Yes
No
Still Attending
Do you have any special skills, additional schooling or degrees received? Please list:
Do you have any military experience?
Yes
No
If YES, what were your dates of service?
What type of education, training or work experience did you receive while in the military?
Former Employers
List your last 3 Employers, starting with the most recent.
Current/Recent Employer:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Phone Number
(with area code)
Position held
Starting
month / year
Ending
month / year
Starting Salary
Final Salary
Supervisor
Last position duties
Reasons for leaving:
Employer #2:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Phone Number
(with area code)
Position held
Starting
month / year
Ending
month / year
Starting Salary
Final Salary
Supervisor
Last position duties
Reasons for leaving:
Employer #3:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Phone Number
(with area code)
Position held
Starting
month / year
Ending
month / year
Starting Salary
Final Salary
Supervisor
Last position duties
Reasons for leaving:
References
List 3 references (other than family members).
Name:
Years known:
Occupation:
Phone Number
(with area code)
Name:
Years known:
Occupation:
Phone Number
(with area code)
Name:
Years known:
Occupation:
Phone Number
(with area code)
Pre-Employment Questionnaire
If you are applying to a position in one of our retail stores, please continue to fill out this section below:
Are you at least 18 years old?
Yes
No
How do you plan on getting to work?
Please indicate below by selecting which days you are available. (Please check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please select the shift(s) you are available. (Please check all that apply)
Morning
Afternoon
Evening
How many hours per week can you work? (Please select one)
20-25 hours
25-35 hours
+35 hours
Are you looking for a long-term permanent or a short-term, position?
Long-term
Short-term
If short-term, about how long do you expect to stay?
Is there any reason you would not be able to arrive to work at your scheduled start time?
Have you ever been fired or forced to resign from any employment?
Yes
No
Comments:
Have you ever been convicted of a crime?
Yes
No
Please Note:
Convictions do not necessarily disqualify an applicant. Factors such as time of offense, nature of violation, seriousness, and rehabilitation will be considered.
If so, when, where and what was the disposition of the case? Comments:
Can you perform the essential duties and meet the physical demands of this job — with or without reasonable accommodation, such as: operating a cash register; mopping floors; stocking shelves; standing for long periods of time; lifting up to 25 pounds; cleaning; and interacting with and communicating with customers, co-workers and the general public in a retail store setting?
Yes
No
How much "money" or "material value" can be taken before you consider it to be stealing?
$1.00
$2.00
$5.00
$10.00
$20.00
$100.00
Any Amount
If your shift starts at 4:00 pm, what time should you arrive for work?
How many times do you believe it is reasonable to call off work for a shift during the course of a month?
Do you have any experience in operating a cash register?
Yes
No
Do you have any experience in operating a Lottery Terminal?
Yes
No
In which state(s):
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Do you know anyone who is employed, or who was previously employed by Smokin' Joe's Tobacco Shop, Inc.?
Yes
No
If Yes, please list their name(s):
Applicant's Statement & Authorization
By signing, (or submitting), below, I certify that the facts contained in this Application are true and complete to the best of my knowledge, and I understand that if employed, falsified statements on this Application shall be grounds for dismissal. I authorize investigation of all statements contained herein, and I authorize the references, and employers listed herein to give Smokin' Joe's Tobacco Shop, Inc., (SJTS, Inc.), any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I release SJTS, Inc. and/or its representatives from any and all liability for damages that may result from ultilization of such information. I understand that if I become employed, I agree to abide by the rules and policies of SJTS, Inc. I understand that my employment is "at will". This means that I do not have a contract of employment for any particular duration, or that limits the grounds for my termination in any way. I am free to resign at any time. Similarly, SJTS, Inc. is free to terminate my employment at any time, for any or no reason. I understand and agree that no representative of SJTS, Inc. has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an officer of SJTS, Inc. I understand that if hired, my employment will be contingent upon SJTS, Inc. approved Background and Criminal Record Check(s). I also understand I will be charged an application fee which will be deducted from my first paycheck for the cost of the Background and Criminal Record Check(s).