Fillable Application For Employment Form printable pdf download

APPLICATION FOR EMPLOYMENT

Forever 21 is an Equal Opportunity Employer

SECTION I. PERSONAL INFORMATION

Last Name____________________________________________ First _____________________________________________________ M.I._________

Current Address _____________________________________________________________________________________________________________

Street

City

State

Zip Code

If different from above,

Permanent Address _________________________________________________________________________________________________________

Street

City

State

Zip Code

Day Phone (______)______-__________ Evening Phone (______)______-_________

Are you 16 or over?

Yes

Are you 18 or over?

Yes

Persons under 16 years of age are NOT eligible for employment at Forever 21

Persons under 18 years of age are NOT eligible for employment at Forever 21 and

and its companies.

its companies in the following states: AL, AR, CA, CO, CT, DE, DC, FL, HI, IN, KY,

LA, MA, MD, ME, MI, MN, NV, NH, NJ, NY, NC, OH, OR, PA, RI, TN, WA, and WI.

Are you a U.S. citizen, permanent resident, or otherwise legally authorized to work in the United States?

Yes

Have you ever applied to Forever 21 or any of its affiliated companies?

Yes

If yes, when & where?__________________________________

Have you ever been employed by Forever 21 or any of its affiliated companies?

Yes

No If yes, when & where? ________________________

IN CASE OF EMERGENCY NOTIFY:

Name______________________________________________ Day Phone________/________-_________ Evening Phone_______/_______-_________

Address___________________________________________________________________________

SECTION II. ADDITIONAL INFORMATION

Have you ever been charged or convicted of a FELONY?

Yes

If yes, please list (include reasons, dates and places)

___________________________________________________

PRE-EMPLOYMENT CERTIFICATION

Please read the following statements carefully before signing this application. Only those applications that are signed and dated are

considered valid. If you have any questions regarding these statements, please ask about them before you sign.

I understand that this application is only valid for the position applied for at Forever 21, Inc., Forever 21 Logistics, LLC, or Forever 21 Retail, Inc.,

collectively the “Company”, and the Company is not obligated to retain or consider this application for current or future openings. I understand that federal

law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment authorization and identity;

failure to submit such proof will result in denial, or termination, of employment.

I authorize investigation of all statements contained in this application and any attachment provided by me. I understand that falsification,

misrepresentation or omission of facts will result in removal of my application from consideration, or if employed, immediate termination.

I authorize the Company to secure information about my experience with former employers, education institutions and agencies and for those parties to

provide information concerning my experience. I hereby release the Company and all of its employees and agents from all claims and liabilities arising

from such investigation or the supplying of information as part of such process. I further understand and agree that identifying this ground for termination in

no way impliedly or expressly alters the at-will nature of my employment with the Company.

If employed by the Company, I will abide by the Company’s policies and rules and standards of conduct. The Company’s business needs may at times

make the following conditions mandatory: overtime or a work schedule other than Monday through Friday. The Company retains sole discretion regarding

the following types and terms and conditions of employment - promotion, demotion, transfers, work assignments, job duties/responsibilities, wage rates and

benefits - or any other terms and conditions that the Company may determine to be necessary for the operation of its business. I understand and accept

these as conditions of my employment.

If I am employed by the Company, I understand my employment is at-will and can be terminated, with or without cause and with or without notice,

at any time at the option of the Company or myself. Only the CEO of the company has the authority to make any agreement contrary to the foregoing,

and then only in writing, signed by me and by the CEO, which expressly refers to the alteration of my at-will employment status. I further expressly agree

that, with respect to the at-will employment relationship, this application and the company's "At-Will" Employment Agreement constitutes the full, complete

and final expression of the parties’ of intent concerning the nature any employment relationship between me and the Company. My signature below

certifies that I agree to be bound by the terms and conditions stated on this application. I understand that this application is not a contract

of employment.

Applicant’s Signature __________________________________________________________________________ Date _______/_________/________

If under 18, Parent/Legal Guardian________________________________________________________________ Date _______/_________/________

Form 0001, Revised 5/20/09