Employment Step 1 of 3 0% Big Al's Bicycle Heaven is an Equal Opportunity Employer. Programs, services, and employment are equally available to everyone. Please inform Big Al's Bicycle Heaven if you require accommodation for the application or interview.Name* First Last Please provide your Mailing and Street Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Position Applied for:* Type of employment desired:* Full-time Part-time Temporary Seasonal Salary Requirement: Date Available to Start* MM slash DD slash YYYY Notes About Your Availability:* How were you referred to us? Are you a US Citizen?* Yes No If not, are you legally allowed to work in the United States? Yes No Have you ever pled "guilty", "no contest", or been convicted of a crime?* Yes No If yes, give dates and details:Answering "yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.Emergency Contact Name:* First Last Emergency Contact Relation:* Emergency Contact Phone:*Education:High School:* High School City and State:* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Did you Graduate?* Yes No College: College City and State: City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Did you Graduate? Yes No Degree: Upload your resume or fill out the section below:Accepted file types: doc, docx, pdf, odf, pages, Max. file size: 5 MB.Previous Employment ( begin with most recent position): Fill out this section of the form or upload a Resume using the File Uploader above.Company Name: Position(s) Held: Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor: Supervisor Phone:Responsibilities:Dates of Employment From: MM slash DD slash YYYY To: MM slash DD slash YYYY Reason for Leaving: Starting Salary: Ending Salary: May we contact this employer as a reference? Yes No Previous Employment:Company Name: Position(s) Held: Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor: Supervisor's Phone:Responsibilities:Dates of Employment From: MM slash DD slash YYYY To: MM slash DD slash YYYY Reason for Leaving: Starting Salary: Ending Salary: May we contact this employer as a reference? Yes No Previous Employment:Company Name: Position(s) Held: Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor: Supervisor's Phone:Responsibilities:Dates of Employment From: MM slash DD slash YYYY To: MM slash DD slash YYYY Starting Salary: Ending Salary: Reason for Leaving: May we contact this employer as a reference? Yes No Fine Print: Any misrepresentation or omission of fact in my application may justify rejecting of, or if employed, termination from employment. Big Al's Bicycle Heaven will investigate my work and personal history and may verify any data given in my application for employment, related documents, or oral statements. I authorize such investigation and the giving and receiving of information requested by Big Al's Bicycle Heaven to assess my qualifications and I release from liability any person giving or receiving any such information. I agree this application can be submitted to the above references/employers to serve as my written release and I agree that a photocopy of this authorization/application shall be considered as effective and valid as the original. I understand that this is an application for employment and that no employment contract is being offered. I understand any oral or written statements to the contrary are hereby disavowed and are not relied upon by me as applicant. I further understand that if I am employed, such employment is for an indefinite period of time and that the company can change wages, benefits and conditions at any time. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without cause and with or without notice - and as such any employee is NOT eligible for Unemployment Compensation. Electronic Signature of Applicant*By typing my full name here I agree to the above statement. Signed on this Date:* MM slash DD slash YYYY
