Beloit
1878 Elmwood Ave | 608-364-4111
430 Broad St | 608-365-7443

Janesville
2720 E. Milwaukee St | 608-755-6133
200 South River St | 608-755-6122

Monroe
105 7 1/2 St | 608-325-9188

Harris Ace Hardware Job Application Form

STATEMENT & AUTHORIZATION TO RELEASE INFORMATION

PLEASE READ THIS STATEMENT CAREFULLY BEFORE YOU COMPLETE THIS APPLICATION

I understand that if I am employed, any misrepresentation or omission of material facts on this application is sufficient cause for dismissal. The company, in considering my application for employment, may verify the information set forth on this application and obtain additional information relating to my background. I authorize all persons, schools, companies, corporations, credit bureaus, license or legal enforcement agencies to supply any information concerning my background. I further agree to submit to alcohol and/or drug screening tests, pre-employment screening practices and security interviews and reviews, if requested of me, at any time prior to or during my employment.

Full Name (By submitting your full name you are authorizing the release of information)

What Are You Applying For?
Contact Information:
Employment Seeking:
Termination Date:
Date you can start work:*
Availability:

Please list your available work hours Monday-Sunday.  Use "Not Available" if unable to work a specific day.
Example:
Monday: 7AM to 9PM
Tuesday: 1:30PM to 9PM
Wednesday: Not Available

Employment History:

Give employment history as completely as possible, starting with your present employer. For any unemployed or self-employed periods - show dates and location (attach additional sheet if necessary). If you have never been employed, list references in place of "Company Name," and give their addresses and phone numbers. We may check other reference sources at our discretion.

Company #1:
Company #2
Company #3
Company #4
Education:
Personal References:

Give the names and addresses of three (3) people (no relatives) you have worked with and to whom we may refer for a reference if necessary. We may also check other sources at our discretion.

Reference #1:
Reference #2:
Reference #3:
General Information:
Application Submission:

I certify that the information contained in this application is correct to the best of my knowledge, and I understand that falsification or omissions in this application in any detail is grounds for disqualification from further consideration or for dismissal from employment at the time the company discovers the omission or falsification. I will be a "Terminable-at-will" employee. My employment and compensation can be terminated with or without cause, with or without notice, at any time, at the option of either the company or myself. I further understand that no personnel recruiter or interviewer or other representative of the company other than the owner/manager has the authority to enter into any agreement for employment for any specified period of time.

Enter Captcha Value:*
captcha