Application For At Will Employment
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8050-3006 Rev. 7/05
EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER
APPLICATION FOR AT-WILL EMPLOYMENT
FOR COMPANY USE
Unit Applied at:
Starting Date:
Job Title:
Unit Hired at:
Starting Rate:
Social Security Number:
Job Code:
PLEASE COMPLETE FULLY — PRINT CLEARLY. READ DISCLOSURE STATEMENTS ON PAGE 3 BEFORE COMPLETING APPLICATION.
Name
Last
First
Middle
Please indicate any other names under which you have worked:
Address
Number
Street
Apt #
City
State
Zip Code
(
)
Home Phone Number
Office Phone Number
Cellular Phone Number
(
)
(
)
Message Phone Number
Name of person where message can be left:
(
)
Yes
No
Are you under 18 years of age?
Were you previously employed by RadioShack Corporation (formerly Tandy Corporation) or one of its subsidiaries?
Yes
No
If yes:
What dates?
From
To
Where?
What position?
What division or subsidiary?
If not, have you previously applied at any RadioShack (or Tandy) location?
Yes
No
If yes:
Date?
Location?
Division or subsidiary?
Have you been convicted of a felony in the past 7 years? (Applicants seeking employment in Hawaii do not answer yes or no, please choose Not
Applicable - Hawaii) (Responding yes to this preliminary question does not necessarily preclude you from being considered for employment. However,
eligibility for employment will be based upon the information contained in your criminal report to the extent allowed by law.)
Yes
No
Not Applicable - Hawaii
If yes, describe in detail:
Yes
No
Are you authorized to work in the United States?
EMPLOYMENT INTEREST
Position Applying For:
Earnings Required:
Available to Start:
Full Time
Part Time
Seasonal/Temporary
$
hr / wk / annual
Total Hours
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Hours
Per Week
Available
A.M.
Each Day
P.M.
We Are Proud To Be A Drug-Free Workplace
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