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EQUAL OPPORTUNITY STATEMENT

Hi-School Pharmacy/Hardware and Affiliates is an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on the basis of race, color, sex, sexual orientation, gender identity, marital status, religion, creed, age, national origin, citizenship status, workers’ compensation status, physical or mental disability, genetic information, veteran status or any other status protected under applicable local, state or federal nondiscrimination law. It is our intention that all applicants be given equal opportunity and that selection decisions are based on job-related factors. Any person needing a reasonable accommodation in the application process should notify the hiring manager. Please print your responses and fill this form out completely in order to have your application considered.
PERSONAL INFORMATION
Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State
Zip Code*
What location are you applying for ?*
Cover Letter & Resume Upload
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EMPLOYMENT HISTORY
(Information may be verified. Telephone numbers are very important.) Please list all work experience, paid or unpaid, beginning with your current or most recent employer and including volunteer work, self-employment and U.S. Military service. If space is insufficient, list on a separate page or additional form. This section must be fully completed.
From
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To
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Position
Company Name
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
May we contact this employer at this time?
Job Duties
Reason for Leaving
Add another previous employer ?
- Yes
- No

EMPLOYMENT HISTORY #2
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Position
Company Name
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
May we contact this employer at this time?
Job Duties
Reason for Leaving
Add another previous employer ?
- Yes
- No

EMPLOYMENT HISTORY #3
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Position
Company Name
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
May we contact this employer at this time?
Job Duties
Reason for Leaving

EDUCATION
Graduated High School ?*
- Yes
- No
- Currently Attending
Name and Location of School (High School)
Have you graduated College ?*
- Yes
- No
- Currently Attending
Have you earned a GED?*
- Yes
- No
Name and Location of College
Degree
Major

ADDITIONAL INFORMATION/SPECIAL SKILLS
ADDITIONAL INFORMATION/SPECIAL SKILLS
Use this space to provide any relevant information about yourself or your background that you feel should be taken into account in considering your application. List specific skills, abilities, training, scholastic honors or scholarships, offices held, certifications, academic activities, or special accomplishments.

REFERENCES #1
Name*
First Last
Email*
Phone*
Business and Occupation*
REFERENCES #2
Name*
First Last
Email*
Phone*
Business and Occupation*
REFERENCES #3
Name*
First Last
Email*
Phone*
Business and Occupation*

APPLICANT’S CERTIFICATION–Please read carefully and check each statement before signing
Consent Drug and Alcohol*
I agree to the Hi-school Pharmacy drug and alcohol policy.*
I understand that the Company reserves the right to condition my employment upon a satisfactory drug test and background check. I further understand
that if I am employed, the Company reserves the right to subject me to drug and alcohol testing if it has reason to believe that I am using drugs or under
the influence of alcohol.
Back Ground Check*
I agree to the Hi-school Pharmacy background check policy.*
I authorize investigation of all information provided during the application process and the references listed above to give the Company any and all
information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release from all liability or
responsibility for this Company, its agents and all persons, companies or corporations providing information to the Company about me.
Policies and Rules*
I agree to the Hi-school Pharmacy policies and rules.*
If hired, I agree to conform to the rules and policies of the Company including the anti-discrimination and harassment policy set forth in the Employee
Handbook. I understand that, if hired, my employment and compensation can be terminated at any time and for any lawful reason, with or without notice,
at the option of either the Company or myself. I further understand that although other terms and conditions of employment may change, this at-will
employment relationship will remain in effect throughout my employment with the Company unless specifically altered by the Senior Vice-President of
Operations in a writing signed by the Chief Operating Officer. This at-will employment relationship may not be modified by any oral or implied agreement
or by a person, statement, act, or pattern of conduct. I understand that no representative of the Company, other than the Senior Vice-President of
Operations have any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the
foregoing.
Policies and Rules*
I agree to the terms and conditions listed bellow.*
I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any
misrepresentation or material omission on this application will result in disqualification for employment. I further understand that, if accepted for
employment, any misrepresentation that becomes known to the Company may result in immediate termination.
Comments
This field is for validation purposes and should be left unchanged.

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PERSONAL INFORMATION

GENERAL INFORMATION

GENERAL INFORMATION

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY #2

EMPLOYMENT HISTORY #3

EDUCATION

ADDITIONAL INFORMATION/SPECIAL SKILLS

REFERENCES #1

REFERENCES #2

REFERENCES #3

APPLICANT’S CERTIFICATION–Please read carefully and check each statement before signing

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