The Purple Onion PO Box 778, Saluda, NC 28773 828-749-1179 We are an Equal Opportunity Employer. All applicants are considered without regard to race, color, religion, disability, sex, national origin, age (for those over 40 or over), or any other basis protected by federal, state, or local law. This employment application is only active for 30 days. After this time a separate employment application must be submitted in order to be considered for employment. Date:__________________ Personal Information First Name__________________ Middle__________________ Last________________________ Street Address _____________________________________________________________ City/State/Zip ________________________________ Phone (___)________________________ How did you find out about this job? __ Newspaper __ Referral __Other _______________________ If hired, do you have a reliable means of transportation? __ Yes __ No Minimum Salary Expected ________________________ Are you at least 18 years old? __ Yes __ No Are you legally eligible for employment in the US? __ Yes __No Have you been convicted of a crime? __ Yes __ No If yes state the nature of the offense and disposition of the case. (NOTE: The existence of a criminal record does not constitute an automatic bar to employment. _____________________________________________________________________________________ Employment Data Are you seeking: __ Temporary __ Full-time __ Part-time What position(s) are you applying for? _______________________ What hours and shift(s) would you prefer to work? ________________________________________ What hours or shift(s) would you prefer not to work? ______________________________________ Are you willing to work overtime? __Yes __ No Weekends? __ Yes __ No Holidays? __Yes __No Are you currently employed? __Yes __No If hired when can you start? ___________________ Are you on layoff or subject to recall? __ Yes __ No Have you ever been discharged or asked to resign from any position? __ Yes __ No If yes, please describe: _____________________________________________________________________________________ Work History (Please list you last four employers. Begin with most recent.) 1. Company_________________________________ Phone No. with Area Code: (___)_____________ Address __________________________________ City/State/Zip ____________________________ Dates of Employment From ________ To _______ Salary Beginning _________ Ending __________ Job Title __________________________________ Supervisor’s Name and Title _________________ Describe Duties ______________________________________________________________________ Specific reason for leaving: _____________________________________________________________ 2. Company_________________________________ Phone No. with Area Code: (___)_____________ Address __________________________________ City/State/Zip ____________________________ Dates of Employment From ________ To _______ Salary Beginning _________ Ending __________ Job Title __________________________________ Supervisor’s Name and Title _________________ Describe Duties ______________________________________________________________________ Specific reason for leaving: _____________________________________________________________ 3. Company_________________________________ Phone No. with Area Code: (___)_____________ Address __________________________________ City/State/Zip ____________________________ Dates of Employment From ________ To _______ Salary Beginning _________ Ending __________ Job Title __________________________________ Supervisor’s Name and Title _________________ Describe Duties ______________________________________________________________________ Specific reason for leaving: _____________________________________________________________