Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

If Hired, Can you furnish proof you are eligible to work in the US? *

Yes

No

Store Location *

Cooper City

Boca Raton

Referred by: *

Employment Agency

School/College

Community Organization

Current Employee

Craigslist

Other Website

Other

Please check each day you are available. Please note, many positions require weekend availabilty: *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Type of Employment. Check all that apply: *

Full-time

Part-time

Temporary

Summer only

When are you willing to work? Check all that apply)

Days (7am - 4pm)

Evenings (4pm - 11pm)

Nights (11pm - 7am)

Overtime

Holidays

Agreement *

I understand and agree that, if hired my employment is "at will" and is not for a definate period and may, regardless of circumstances, be terminated at any time without prior notice by the Company. I further acknowledge that no contract of employment will be valid against the company unless signed by the Chief Operating Officer of the Company. I acknowledge that as a condition of my employment, I will be required to agree to be bound by the terms of and sign the Company. Failure to sign this Agreement shall result in revocation of my offer of employment.

I ACCEPT

I DO NO NOT accept