Employment

Please print these pages, fill them out, and bring them to the Big R location you would like to apply! Or you can FAX the filled out form to 866-298-6019.

** IMPORTANT **

Employment Opportunities is only for the following stores:

BIG R STORES

Application for Employment

Federal law obligates us to provide reasonable accommodation to the known disabilities of applicants and employees, unless to do so would pose an undue hardship. Please let us know if you need an accommodation to complete the application process or to perform any essential elements of the position sought.

Application good for 60 days. All questions must be fully answered before the Company will consider your application. State the facts. Employees may be terminated after hiring for misrepresentation on this application.

*We are an equal opportunity employer.

DATE:___________________
NAME:____________________________________
TELEPHONE: (____)____________
EMAIL ADDRESS:____________________________
PRESENT ADDRESS:____________________________
DATE AVAILABLE:________________
POSITION APPLIED FOR:______________________

REFERRED BY: ADVERTISEMENT ____ CURRENT EMPLOYEE ____
PRIVATE EMPLOYMENT AGENCY ____ EDUCATIONAL INSTITUTION ____
STATE EMPLOYMENT SERVICE ____ WALK-IN ____ OTHER ____

ARE YOU 18 YEARS OF AGE OR OLDER? YES / NO (circle one)
ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY?
YES / NO (circle one)

If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance with the Immigration Reform and Control Act of 1986. While you need not provide this proof of citizenship or immigration status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired.

PREVIOUS WORK EXPERIENCE
Give employment record as completely as possible, starting with your present or last employer. Attach an additional sheet if necessary. Exclude names which indicate, for example, race, color, religion, sex, disability or national origin. For any unemployed or self-employed periods, show dates and locations.

Company ______________ Address_____________________________________
City ______________________ State ____________________ Zip Code________
Employed From (mo/yr) ____________ To _____________ Rate of Pay ________
Job Title ____________________ Supervisor ________________________
Reason for Leaving _______________________________________
May We Contact? Yes/No (circle one)

EDUCATION/ EXPERIENCE
Please list all education or specialized experience or other qualifications which you feel relates to the position(s) applied for and which would help you, such as schools, colleges, military training, accomplishments, experience, etc. Exclude names which indicate, for example, race, color, religion, sex, disability or national origin.

SCHOOLS.....
NAME ADDRESS DEGREES SPECIAL ACHIEVEMENTS/EXPERIENCE
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________

Have you ever been convicted of a crime for anything other than a minor traffice violation?
Yes/No (circle one)

IF YES, PLEASE EXPLAIN:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

REFERENCES (Other than family or employers)

NAME:_____________________________
ADDRESS:__________________________
PHONE:
DAY ______________________________
NIGHT_____________________________

WHICH OF OUR 8 LOCATIONS ARE YOU APPLYING FOR (please circle store):
NOTE: Applications are ONLY FOR THESE STORES!!

Watseka
Gibson City
Danville
Tilton
Pontiac
Morris
Warsaw
Rent all Center in Danville

*AN EQUAL OPPORTUNITY EMPLOYER

It is the policy of this company to provide equal employment opportunity to all employees and applicants for employment without regard to race, color, religion, sex, national origin, handicap, age, ancestry, marital status, unfavorable military discharge, veterans status, citizenship status, or any other status entitled to protection under state or federal law, and to make employment decisions consistent with this principle of equal employment opportunity. To this end, this company affirmatively seeks to employ and advance for employment, qualified disabled veterans, veterans of the Vietnam era and conducts all employment activities, including but not limited to, hiring, promotion, demotion, transfer, recruitment, advertising, layoff, discharge, rates of pay, and selection for training without regard to race, color, religion, sex, age, ancestry, marital status, unfavorable military discharge, or national origin, citizenship status or any other status entitled to protection under State or Federal law.

APPLICANT'S STATEMENT

These answers are true and complete to the best of my knowledge. The Company may investigate all statements contained in this application, and I understand that any false or misleading information provided may result in my immediate discharge. I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT AND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN MYSELF AND THE COMPANY IS TERMINABLE-AT-WILL. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.

I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor selected by the Company, to determine whether I can perform the job duties. In addition, I understand a drug test will be required. I also understand that if I am employed by the Company, I may be required to submit to lawful searches of my property or person in certain instances.

I authorize the Company to make a thorough investigation of my past employment education and job-related activities and I release from all liability all persons, companies, and corporations supplying such information. I also indemnify this Company against any liability which might result from making such investigation.

Additionally, I authorize the Company to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that the Company deems appropriate.

Signature _____________________________ Date ___________________________________

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