Shirley’s Deals Shirley’s Deals Job Application Applicants Full Name * First Name Last Name Date Of Birth * MM DD YYYY Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Number of hours per week desired? * Days desired? * Position interested in? * Who referred you? Their phone number? (###) ### #### Have you worked with Shirleys Way before? * Yes No If yes when? MM DD YYYY Are you willing to work any shift, including nights and weekends? Yes No If no, please state your limitations If offered the job, when would you be able to start? * MM DD YYYY If hired, are you able to submit proof that you are legally able to work in the United States of America? * Yes No Which Shirley's Way Deals location would you prefer? * Valley Station PRP Expo 5 Brandenburg Hillview Employment History List your current or most recent employment first. Employer Name 1 * Supervisors Name First Name Last Name Employer Address Address 1 Address 2 City State/Province Zip/Postal Code Country Position Job duties? Reason for leaving? Date of employment MM DD YYYY Employer Name 2 * Supervisors Name First Name Last Name Employer Address Address 1 Address 2 City State/Province Zip/Postal Code Country Position Job duties? Reason for leaving? Date of employment MM DD YYYY Additional employment history References Reference 1 * First Name Last Name Phone (###) ### #### Relationship to reference Reference 2 * First Name Last Name Phone (###) ### #### Relationship to reference Reference 3 * First Name Last Name Phone (###) ### #### Relationship to reference By clicking submit, you are authorizing Shirley's Way Deals to use the data collected to perform a thorough review Applicants will have background checks per state of Kentucky Thank you! Someone from the Shirley’s Way Deals team will be review the application. Become a $10 Monthly Donor
