Employment Application

Contact Information

Name*

First Name Middle Initial Last Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone Number*

Cell Phone Number

Education, Training and Skills Information

High School Attended*

Did you graduate?

Yes

No

Still Attending

GED

High School City and State

Subjects Studied

Degree

College or Trade School Attended

Did You Graduate?

Yes

No

Still Attending

College City and State

Degree

Major Studied

Do you have any Military Experience, special skills, additional schooling or degrees received? Please list.

Former Employers

Disregard Starting salary / Final salary if applicant is applying for employment in the state of Delaware.

NOTE: This question may be asked if the applicant has been extended and accepted an offer of employment in the state of Delaware.

List information about your last 3 employers, starting with the most recent first.

Employer 1

Employer Name

City and State

Phone Number

Start Date

End Date

Supervisor's Name

Job Title

Last Position's Duties

Starting Salary

Ending Salary

Reason For Leaving

Employer 2

Employer Name

City and State

Phone Number

Start Date

End Date

Supervisor's Name

Job Title

Last Position's Duties

Starting Salary

Ending Salary

Reason For Leaving

Employer 3

Employer Name

City and State

Phone Number

Start Date

End Date

Supervisor's Name

Job Title

Last Position's Duties

Starting Salary

Ending Salary

Reason For Leaving

Explain any periods of unemployment during the last 5 years

From

To

Reason

From

To

Reason

References

Name

Years Known

Occupation

Phone Number

Name

Years Known

Occupation

Phone Number

Name

Years Known

Occupation

Phone Number

Applicant's Statement and Authorization

I certify that the facts contained herein are true and complete to the best of my knowledge. I understand that if employed, false statements, or omission of materially relevant information on this Application, or the omission of any information that may be of concern discovered by Smokin’ Joe’s Tobacco Shop, Inc’s (SJTS, Inc.) shall be grounds for dismissal, whenever discovered.

I authorize investigation of my background, and of all statements contained herein, from all sources, public and private, including but not limited to criminal, consumer, or credit reports, and I authorize the references and employers listed herein to give SJTS, Inc. all information concerning my previous employment and all pertinent information, personal or otherwise. I release SJTS, Inc. and its employees, agents and representatives from all liability for damages that may result from use of such information.

If hired, 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 specified period, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an SJTS, Inc. officer.

If hired, my employment will be contingent upon SJTS, Inc. approved Background and Criminal Record Check(s). I understand that I will be charged a fee which will be deducted from my first paycheck for the cost of the record checks.

SJTS, Inc. may request, after a job offer has been made, or during my employment, that I undergo drug testing and/or a medical exam. I consent thereto now and in the future. If such testing is required a satisfactory result is a condition of employment.

I am signing below electronically. I agree my electronic signature is the legal equivalent of my handwritten signature.

Applicant's Signature (please enter your full name)

Today’s Date:
03/31/2025

Contact Information

Employment Information

Education, Training and Skills Information

Former Employers

Employer 1

Employer 2

Employer 3

Explain any periods of unemployment during the last 5 years

References

Additional Information

Applicant's Statement and Authorization