Form 8850 - Big Lots Job Application Form - Job Application Review
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4BIG LOTS
EMPLOYMENT APPLICATION
This application is considered active for ninety (90) days.
DRUG-FREE WORKPLACE
All employees are subject to drug and alcohol testing
PERSONAL DATA
procedures permitted under federal and state law.
WOTC Registration #
Please complete in ink.
Name (Last, First, Middle)
Contact Phone Number
Street Address
City
State
Zip
E-mail Address
Position(s) interested in?
Salary Requirements
Are you under the age of 18?
Yes
No
Hour/Year
(Circle One)
If yes, state your age.
Have you ever worked for Big Lots before?
Yes
No
If yes, when and where?
If hired, can you supply proof that you are legally entitled to work in the United States for any employer?
Yes
No
Do you have friends or relatives working for us?
Yes
No
If so, who?
Can you work:
Anytime
Days
Evenings
Weekends
Are there any times or days you cannot work?
Have you ever been convicted of (1) a violent crime (i.e., assault, battery, murder, etc.), (2) a retail related crime (i.e., shoplifting, credit card fraud, robbery, theft,
burglary, etc.), or (3) drug trafficking/distribution?
Yes
No
Note: A “yes” response will not automatically disqualify you from employment, but will be considered as part of your overall job-related qualifications for
employment. You do not need to disclose any information regarding arrests or any criminal charges and/ or convictions that have been erased, annulled, sealed
and/or expunged from your record.
If yes, please describe:
EDUCATION
Last Year
Did You Earn a
Type of School
Name of School
Location of School
Area of Study
Completed
Degree or Diploma?
High School
1 2 3 4
Yes
No
College
1 2 3 4
Yes
No
Graduate
1 2 3 4
Yes
No
Other
1 2 3 4
Yes
No
REFERENCES
List names of three people (other than relatives) we may contact who have knowledge of your job-related skills.
Name
Telephone Contact/E-mail Contact
Address/City/State
Occupation
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CONTINUED ON BACK
AN EQUAL OPPORTUNITY EMPLOYER
Big Lots is an Equal Opportunity Employer and does not discriminate in making employment decisions based upon race,
color, sex, religion, national origin, age, disability, marital status, sexual orientation, or veteran or military status.
SOS SKU# 960600043 • 0 8 /12
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Parent category: Business