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Application for Employment

Personal Information

Desired Employment

Modern Shoe, Inc. may require a Background of Criminal Investigation (BCI) for employment of certain job positions.

(A conviction record will not necessarily disqualify you for employment. This information will be used only for job-related purposes and only to the extent permitted by applicable law.)
(Proof of citizenship or immigration status will be required upon employment.)

Hours Available (please enter the hours you are available to work Monday through Saturday):

(8am - 6pm)
(8am - 6pm)
(8am - 6pm)
(8am - 7pm)
(8am - 7pm)
(8am - 7pm)

Education

Prior Work Experience

List below your last three employers, starting with your present or most recent job.

References

List below 3 persons not related to you, whom you have known for at least one year.

Authorization

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal of I have been employed, no matter when discovered by Modern Shoe, Inc.

I understand that any employment in conditioned on a background check. I authorize Modern Shoe, Inc. to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to Modern Shoe, Inc. without giving me prior notice of such disclosure. In addition, I release Modern Shoe, Inc., any former employers, and all references listed above from any and all claims, demands, or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be *at will* and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or Modern Shoe Inc. No promises regarding employment have been made to me and I understand that no such promise of guarantee is binding upon Modern Shoe, Inc. unless made in writing

If hired, I agree to abide by all Modern Shoe, Inc. work rules, policies, and procedures. Modern Shoe, Inc. retains the right to revise its policies or procedures, in whole or in part, at any time.