Fillable Kohl'S Employment Application (Page 2 of 3) in pdf

We conduct pre-employment drug screening for some positions. Are you willing to submit to a drug test?

Yes_______ No _______

BEFORE ANSWERING THE FOLLOWING QUESTIONS, PLEASE REFER TO THE INSTRUCTIONS THAT FOLLOW IF YOU ARE APPLYING FOR A POSITION IN CALIFORNIA, CONNECTICUT,

ILLINOIS, MASSACHUSETTS, NEW YORK, UTAH, or WASHINGTON.

Have you ever been convicted of or plead guilty to a crime? (Answer NO for any annulled, expunged or sealed records; minor traffic offenses; or any conviction that was pardoned, discharged, or dismissed upon condition of

probation).

Yes _____ No _______

If you checked “Yes,” please explain below. A criminal conviction will not necessarily be a bar to employment. To help us evaluate your application, please describe the nature of the crime and your subsequent rehabilitation.

If yes, provide details__________________________________________________________________________________________________________________________________________________________________

INSTRUCTIONS - CRIMINAL CONVICTIONS QUESTIONS

California Applicants: You may answer “No Record” with respect to any conviction for a marijuana offense if the conviction occurred more than two years prior to the date this application is completed. In addition, do not

provide any information regarding a referral to and participation in any pre-trial or post-trial diversion program.

Connecticut Applicants: You are not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased. Conn.Gen.Stat. Sections 46b-146, 54-76o or 54-142a. Criminal records

subject to erasure pursuant to Conn.Gen.Stat. Sections 46b-146, 54-76o or 54-142a are records related to (a) determinations of “delinquency” or that, as a child, you were a member of a family with service needs, (b) a ruling

you are a “youthful offender”, (c) a finding you are not guilty for a criminal charge, or (d) a conviction for which you have received an “absolute pardon”. Any person whose criminal records have been erased pursuant to Conn.

Gen.Stat. Sections 46b-146, 54-76o or 54-142a shall be deemed to never have been arrested within the meaning of the general statutes with respect to the proceedings so erased and may so swear under oath.

Illinois Applicants: You are not required to reveal any expunged convictions, including expunged juvenile convictions.

Massachusetts / City of Philadelphia Applicants: In Massachusetts and the City of Philadelphia only, DO NOT answer YES OR NO or provide any information of your criminal history.

New York Applicants: You may answer “No Record” with respect to any youthful offender conviction.

Utah Applicants: You may answer “No Record” with respect to any conviction for a misdemeanor or summary offense.

Washington Applicants: Answer “Yes” only if the conviction or release from imprisonment was within the last ten (10) years, or related to the functions of the position for which you are applying.

ADDITIONAL STATE INFORMATION

Maryland / Massachusetts Applicants: It is unlawful for an employer to require or demand as a condition of employment, prospective employment, or continued employment, that any individual submit to or take a lie detector or

similar tests. An employer who violates the law is subject to criminal penalties and fines.

Rhode Island Applicants: Kohl’s is subject to Chapters 29-38 of Title 28 of the General Laws of Rhode Island and is therefore covered by the state’s workers’ compensation law.

APPLICANT’S STATEMENT

I have read and fully understand the questions asked in this application. I certify that all of the answers I have given are true, accurate and complete. I understand that the omission and/or misrepresentation of any

fact from or on this application or during any interview will result in immediate rejection of my application or if I am hired will be cause for immediate dismissal. Unless I noted otherwise, I authorize the Company

to contact all my employment references and personal references, as well as the education institutions I have attended. I further authorize the Company to inquire about, investigate and obtain copies of any records

which relate to me from my former employers and educational institutions. I hereby release Kohl’s and all affiliated persons and entities, as well as any person or institution that provides Kohl’s with any lawful

information about me, from any and all liability whatsoever resulting from any such lawful inquiry, investigation or communication.

If hired, I agree to abide by all of the rules and regulations of the Company. I understand and agree that nothing in this application shall constitute an offer, a contract or a guarantee of employment for a specific

period of time. If hired, I understand that my employment is at-will and may be terminated with or without cause and with or without notice at any time, at the option of either Kohl’s or myself. I further understand

that no representative or agent of the Company, other than the Senior Vice President of Human Resources, has the authority to enter into any agreement for employment for any specific period of time, or to make an

agreement contrary to the foregoing. I also understand that any agreement modifying my at-will employment status must be in writing and signed by the Senior Vice President of Human Resources. In addition, I

understand that the Company and all plan administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures,

benefits or other terms and conditions of employment. I understand that any hiring decision is contingent upon my successful completion of all of the Company's lawful pre-employment checks, which may include

a background check. I agree to execute any consent forms necessary for the Company to conduct its lawful pre-employment checks.

Signature ___________________________________________________

Date____________________________________

AR-017E

07/2011