Kohl’s Department Stores is an Equal Employment Opportunity Employer and gives all applicants for
employment equal consideration regardless of race, color, sex, religion, national origin, ancestry, age, physical
or mental disability, sexual orientation, transgender status, genetic information, marital status, citizenship
Date
status, veteran status, pregnancy, height, weight, or any other status protected by federal, state or local law.
EMPLOYMENT APPLICATION
Upon request and consistent with applicable laws, Kohl’s will provide reasonable accommodations to
individuals with disabilities who need an accommodation to fully participate in the application process.
Name
Home Number
Last
First
Middle
Address
Cell Number
Street
City
State
Zip
List any additional names which you have used which will permit us to check your work record:
Position Applied For
Date available to start work:
AVAILABLE TO WORK:
SUN
MON
TUE
WED
THU
FRI
SAT
FROM
Full
(START TIME)
Time
TO
Part
(END TIME)
Time
Have you ever applied at or been employed by Kohl’s before?
If yes, please give dates & location
Have you ever worked for Kohl’s in the capacity of a temporary employee and/or contracted employee? _______________ If yes, please explain. __________________________
Are you legally entitled to work in the United States?
If hired, can you provide documentation of this eligibility?
Are you 18 years of age or older?_______________ If no, state your age _________________
Do you have any friends or relatives employed by Kohl’s?
If yes, give names and locations
Employment History – First list all current employment, then list all previous employment.
From
To
Position Title
Starting
Ending
Mo./Yr.
Mo./Yr.
Supervisor’s Name
Salary
Salary
Reason for Leaving
Company Name and Address
/
/
1.
/
/
2.
/
/
3.
/
/
4.
Please explain all periods of unemployment:
/
/
Reason
From
To
/
/
Reason
From
To
/
/
Reason
From
To
AR-017E
07/2011