APPLICATION FOR EMPLOYMENT
rue21 is an equal opportunity employer dedicated to non-discrimination in employment. rue21 selects the best qualified individual for the job based on job-related qualifications
regardless of race, color, age, sex, religion, national origin, mental or physical disability, ancestry, marital status, veteran status or any other status protected by applicable law.
All statements by applicants for employment on the application will be carefully checked for accuracy. Please provide only the requested information below. We reserve the
right to reject any application that contains information beyond that which is specifically requested. The use of this form does not mean there are positions open and does not
obligate us in any way.
Date of Application
Are you at least 16 years of age? No
Are you eligible to work in the United States? No
If below the age of 18, may be required to provide verification of permission to work.
All hires will be required to provide proof of eligibility to work in the United States.
Do you have any relatives currently employed by rue21? No Yes – Name of relative:
Have you ever been discharged from a job?
In select jurisdictions employers are prohibited from making written, pre-employment inquiries of an applicant about his
or her criminal history. APPLICANTS IN THE FOLLOWING LOCATIONS SHOULD NOT RESPOND TO ANY OF THE
No Yes – Please explain below:
QUESTIONS SEEKING CRIMINAL RECORD INFORMATION: Massachusetts; Hawaii; Rhode Island; Minnesota;
Newark, NJ; Buffalo, NY; Seattle, WA; Philadelphia, PA.
Have you ever been convicted of a crime other than minor traffic violations or
misdemeanor convictions for which probation was completed?
Note: A conviction will not necessarily disqualify you from employment.
No Yes –
Please list the nature of the crime(s), date, place of conviction and legal disposition of the case.
Position applying for
(check all that apply, indicating part-time or full-time when applicable):
FT or PT
FT or PT
Have you ever worked for or applied for a position
At which rue21 location
with rue21 before?
are you seeking
Are you able to work overtime? No
Which location? _______________________
available to work:
I certify that the information provided in this Application (front and back) is complete, accurate and true in all respects. I hereby authorize rue21, inc. by and through its agents to thoroughly
investigate all representations made by me in the Application, including but not limited to conducting a background check into my background, references, driving record, criminal record,
employment record and other matters related to my suitability for employment. In connection therewith, I agree to sign and return with this application a Consent to Obtain Consumer Report and
Criminal Background Information in the form provided by rue21 with this Application. I authorize any persons, schools, my current employer (if applicable), and previous employers and
organizations contacted by rue21 to provide any relevant information regarding my current and/or previous employment and I release all persons, schools and employers from any and all claims
resulting from providing such information. I understand that my misrepresentation or omission of facts may result in the rejection of this Application, or if hired, discipline up to and including
dismissal. I further understand that this Application is not a contract and does not create an employment relationship.
For rue21 Use Only
Applicant Signature _______________________________________________ Date______________
Store # (if applicable) ______________
PLEASE CONTINUE ON BACK PAGE