Page 1 of 3 (General Information) General Information Personal First Name * Last Name * Address Line 1 * Address Line 2 Example: Apartment 123 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Phone Number * Example: 123.456.7890 Email Previous Bucky's employment Have you applied at Bucky's before? * Yes No Date applied * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20112012201320142015201620172018201920202021 Have you worked at Bucky's before? * Yes No Location of previous Bucky's employment * Employment Start * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2006200720082009201020112012201320142015201620172018201920202021 Employment End * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2006200720082009201020112012201320142015201620172018201920202021 Current application How were you referred to Bucky's? * Bucky's Store Friend/Relative Internet Newspaper School Bucky's Employee Bucky's Website Are you at least 19 years old? * Yes No Do you have reliable transportation? * Yes No What position are you applying for? * - Select -Customer Service/CashierCookFloor AttendantMaintenanceMechanicStore ManagerAsst. Store ManagerTransport DriverWarehouse DriverWarehouse PickerCustomer Service/CashierCookFloor AttendantMaintenanceMechanicStore ManagerAsst. Store ManagerTransport DriverWarehouse DriverWarehouse PickerCustomer Service/CashierCookFloor AttendantMaintenanceMechanicStore ManagerAsst. Store ManagerTransport DriverWarehouse DriverWarehouse PickerCustomer Service/CashierCookFloor AttendantMaintenanceMechanicStore ManagerAsst. Store ManagerTransport DriverWarehouse DriverWarehouse PickerCustomer Service/CashierCookFloor AttendantMaintenanceMechanicStore ManagerAsst. Store ManagerTransport DriverWarehouse DriverWarehouse Picker To list the available positions for a different market area, click on "Select a different market" at the top of this page and select that market area. Do you have a current driver's license? * Yes No When can you begin work? * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202120222023 How many hours per week do you want to work? * Desired Starting Pay * AvailabilityBucky's is open 24 hours a day. Indicate the days you are available to work each week. Are you willing to work * Evenings? Overnights? Weekends? Holidays? Are you available on * Mondays? Tuesdays? Wednesdays? Thursdays? Fridays? Saturdays? Sundays? Skills and Abilities List anything you would like to be considered Such as special qualifications, training, education, skills, or experience Business equipment operating abilities Applicable to the job position you are applying for Education Highest elementary or high school grade completed * - Select -123456789101112 Did you graduate from high school? * Yes No Did you obtain a GED? * Yes No Do you have secondary education? * Yes No Type * - Select -CollegeUniversityBusiness schoolTrade school Major Degree Conferred Credit hours
