Items marked in red are required.

• Name of Position

  Name of Position

• Preferred Store
  Michaels Jewelers Danbury - Danbury, CT Michaels Jewelers Manchester - Manchester, CT Michaels Jewelers Torrington - Torrington, CT Michaels Jewelers Orange - Orange, CT Michaels Jewelers Farmington - Farmington, CT Michaels Jewelers Bristol - Bristol, CT Michaels Jewelers Trumbull - Trumbull, CT Michaels Jewelers Waterbury - Waterbury, CT Michaels Jewelers Meriden - Meriden, CT Michaels Jewelers Avon - Avon, CT Pandora Tucson Mall - Tucson, AZ Pandora Park Place - Tucson, AZ PANDORA Stamford - Stamford, CT PANDORA Danbury - Danbury, CT PANDORA Westfarms - Farmington, CT PANDORA Edison - Edison, NJ PANDORA Paramus - Paramus, NJ PANDORA Wayne - Wayne, NJ Pandora Coronado - Albuquerque, NM PANDORA White Plains - White Plains, NY
  

  Store Name and Location

• Are you willing to work at another location?
  If checked, maximum # of travel miles:

  Willing to work at another location?

• Type of Work Desired
  Full Time | Part Time | Seasonal

  Type of Work Desired

• Specify days and hours if you selected "Part Time" or "Seasonal"

  Days and Hours Available to Work

• If necessary, are you available to work beyond your regularly scheduled hours or work overtime with extended or short notice?
   Yes  No

  Are you available to work beyond your regularly scheduled hours?

• Date Available to Start Work
  / MM / DD YYYY
• Rate of Pay Expected
  $ per

  Rate of Pay Expected

• Name

  Full Name

• Address

  Current Street Address

• City

  City

• State
  AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  State

• Zip

  Zip

• Cell Phone

  Cell Phone

• Home Phone

  Home Phone

• Email

  Email Address

• Please list any and all prior addresses for the last 10 years:

  Please list any and all prior addresses for the last 10 years

• Have you ever applied for a job with this company in the past? If yes, please give the date of the application and the position for which you applied. State your name at that time, if different than at present.
   Yes  No Explanation if yes:

  Question 1

• Have you ever been employed by this company in the past? If yes, please give dates of employment, position(s) held, and state your name while employed if different from at present.
   Yes  No Explanation if yes:

  Question 2

• Do you have any relatives who are employed by this company? Please specify if yes.
   Yes  No Explanation if yes:

  Question 3

• If hired will you be able to work any day or hours required for the position(s) for which you are applying? This will include: Saturdays, Sundays, evenings, overtime and extra hours throughout the year. If no, please explain.
   Yes  No Explanation if no:

  Question 4

• Are you currently subject to a non-compete, non-solicitation, employment agreement or any other obligation with another employer that could affect your ability to perform the job for which you are applying?
   Yes  No

  Question 5

• If so, please explain and submit documentation along with your application:

  Please explain and submit documentation along with your application

• Are you 18 years of age or over?
   Yes  No If not, do you have a permit to work? (If yes, you will be required to furnish a copy of the work permit.)  Yes  No

  Question 6

• Are you legally authorized to work in the United States? (If yes, you will be required to verify your authorization to work in the United States.)
   Yes  No

  Question 7

(List the last 10 years work experience begining with most recent.)

Employer 1

Dates of Employment From: / MM / DD YYYY To: / MM / DD YYYY	Company Name Company Address	Salary/Hourly Rate Start Pay: End Pay:
Job Title Your Name If Different From Present Name	Supervisor Name Supervisor Phone (if known)
Responsibilities and Duties	Reason for Leaving

Employer 2

Dates of Employment From: / MM / DD YYYY To: / MM / DD YYYY	Company Name Company Address	Salary/Hourly Rate Start Pay: End Pay:
Job Title Your Name If Different From Present Name	Supervisor Name Supervisor Phone (if known)
Responsibilities and Duties	Reason for Leaving

Employer 3

Dates of Employment From: / MM / DD YYYY To: / MM / DD YYYY	Company Name Company Address	Salary/Hourly Rate Start Pay: End Pay:
Job Title Your Name If Different From Present Name	Supervisor Name Supervisor Phone (if known)
Responsibilities and Duties	Reason for Leaving





• Have you ever worked under another name? If yes, please state when and under what name?
   Yes  No Other Name if yes:
• Have you ever been dismissed from any job other than layoff? If yes, please state which employer(s) and why:
   Yes  No Explanation if yes:
• Is there any reason why any of your past employers would give you a negative reference? If yes, which employer(s) and why:
   Yes  No Explanation if yes:
• May we contact your present and/or past employers? If no, which employer(s) and why:
   Yes  No Explanation if no:

CONVICTION OF CRIMINAL OFFENSES
**IMPORTANT NOTICE REGARDING CRIMINAL CONVICTIONS. A “yes” response to the following question may not automatically disqualify an applicant from employment. Also, applicants for employment in Connecticut and/or New York should answer the question subject to the following applicable qualifications:

· Applicants for Employment in Connecticut: Please note that you are not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased under the Connecticut General Statutes. The criminal records subject to erasure are records pertaining to a finding of delinquency or that a child was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge that has been dismissed or nolled, a criminal charge for which the person has been found not guilty or a conviction for which the person received an absolute pardon. Any person whose criminal records have been erased shall be deemed to have never been arrested within the meaning of the general statutes with respect to the proceeding so erased and may so swear under oath.

· Applicants for Employment in New York: Please note that you are not required to disclose any criminal proceeding that was terminated in your favor, any conviction that has been sealed, or any criminal proceeding that terminated in a youthful offender adjudication.

• Have you ever been convicted of a felony or a crime involving theft, dishonesty or a breach of trust in the past seven years which has not been pardoned, annulled, expunged or sealed by a court? If yes, please indicate the date of the conviction and describe the incident, city, state and charge:
   Yes  No Explanation if yes:




Educational Data

High School
• Name of School

  Name of High School

• City State AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  City and State of High School

• Highest Grade Completed
6th7th8th9th10th11th12th
• Grade Point Average

  Grade Point Average (Ex. 3.2)



Technical Vocational Business or Other Training
• Name of School
  Did You Graduate?  Yes  No

  Name of School / Graduate?

• City State AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  City and State of Technical Vocational Business or Other Training

• Degree / Diploma / Certificate

  Degree / Diploma / Certificate

• Grade Point Average

  Grade Point Average (Ex. 3.2)

• Major / Course of Study

  Major / Course of Study



College or University
• Name of School
  Did You Graduate?  Yes  No

  Name of College or University / Graduate?

• City State AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  City and State of College or University

• Degree / Diploma / Certificate

  Degree / Diploma / Certificate

• Grade Point Average

  Grade Point Average (Ex. 3.2)

• Major / Course of Study

  Major / Course of Study



Graduate School
• Name of School
  Did You Graduate?  Yes  No

  Name of Graduate School / Graduate?

• City State AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  City and State of Graduate School

• Degree / Diploma / Certificate

  Degree / Diploma / Certificate

• Grade Point Average

  Grade Point Average (Ex. 3.2)

• Major / Course of Study

  Major / Course of Study



Professional Seminar
• Name of Program

  Name of Program

• Date Attended
  / MM / DD YYYY

  Date Attended

• City State AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

  City and State of Program Attended

• Details

  Details of Program Attended




References

Reference 1
• Name

  Reference Full Name

• Address

  Reference Address, City, State, Zip

• Phone

  Reference Phone

• Occupation

  Reference Occupation

Reference 2
• Name

  Reference Full Name

• Address

  Reference Address, City, State, Zip

• Phone

  Reference Phone

• Occupation

  Reference Occupation

Reference 3
• Name

  Reference Full Name

• Address

  Reference Address, City, State, Zip

• Phone

  Reference Phone

• Occupation

  Reference Occupation




Other Job Related Experience

• Some people gain job related experience in positions other than as an employee. For example, an accountant may gain experience as a treasurer of a civic or school organization, or a manager may gain experience while working on civic projects. Please list and describe any paid or unpaid activities, honors, experience, or training that might aid you in performing the job(s) for which you have applied and have not been listed previously in this application.
  
  

  Other Job Related Experience



• Please add any additional information that you think may be relevant to a decision to hire you. (Example: Job related seminars, short courses, workshops, or other education experiences.)
  
  
  

  Additional Information




***IMPORTANT***

***PLEASE READ***

• At-Will Employment: I understand that this is an application for employment and that nothing contained in this application or in the interview process is intended to create an employment contract. I understand that if I am employed, such employment is at-will and for an indefinite period of time and that the Company has a right to terminate my employment at any time and for any reason, with or without cause, and I retain a similar right. The Company also has the right to change schedules, wages, benefits and other terms and conditions of my employment at any time. I further understand that no manager or representative of the Company, other than a duly authorized officer of Michaels Inc. has any authority to enter into an agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. The employment at-will policy may only be changed with respect to an employee if the Company enters into a formal written agreement that expressly changes the at-will employment relationship and that is duly executed by a duly authorized officer of Michaels Inc.


• Compliance with Company Policies: In the event of my employment by the Company, I will comply with all rules and regulations as set forth in the Company’s policies or the communications distributed to employees.


• No False or Misleading Information: I have read and fully understand the questions asked in this application for employment. I certify that all of the answers I have given are true, accurate and complete. I further certify that there are no misrepresentations, omissions, or falsifications in any statements or information that I will or have provided in connection with my application for employment, and that all such information and statements given are true, complete and accurate to the best of my knowledge and are made in good faith. Without limiting the at-will status of my employment if I am hired, I understand that any false or misleading statements or the withholding of any pertinent information by me, no matter when discovered, will disqualify me from further consideration as a candidate for employment or may result in the termination of my employment if I am employed.


• Notification of Changes: I understand and agree that if any of the information I have provided in this application changes during the application process, I must promptly notify the Company of any such change and provide information related to such change. I further understand and agree that I must promptly notify the Company if I should be convicted of a felony or any crime involving theft, dishonesty or a breach of trust while my employment application is pending or during my employment, if hired.


• Employment References: Unless otherwise noted, I authorize the Company to contact my current and former employment references, educational institutions that I attended, personal references that I have provided, and other relevant third parties. I further authorize the Company to inquire about, and authorize my former employers, educators, personal references, and others to furnish the Company with information and records regarding my education, employment history, and to verify and obtain additional information related the information I have provided in the application and recruitment process and/or to discuss my background, past performance and/or suitability for employment. I hereby release the Company and all affiliated persons and entities, as well as any third party that provides the Company with any lawful information, from any and all liability whatsoever resulting from such lawful inquiry or communication.


• Background Checks: I understand I may not receive further consideration for a position if all items contained on this application are not thoroughly completed. I further understand that any hiring decision is contingent upon my successful completion of all of the Company's lawful pre-employment checks because if hired, I will have access to customers’ personal and/or financial information (e.g., social security numbers, credit card information, credit history, etc.) as well as to the Company’s assets. Such pre-employment checks may include a pre-employment criminal background check, credit report, consumer report and/or an investigative consumer report from a consumer reporting agency as to my character, general reputation, personal characteristics and mode of living. I agree to execute any consent forms necessary for the Company to conduct its lawful pre-employment checks. I further understand that the Company reserves the right to obtain subsequent reports during the course of my employment, if hired, in deciding whether to continue my employment and when making other employment related decisions directly affecting me on an as-needed basis.


• Non-Disclosure of Confidential Information: I represent that I have not disclosed and will not disclose to the Company, and will not use, or induce the Company to use, any confidential information or trade secrets of others at any time, including but not limited to any confidential information or trade secrets of any former employer. I further represent that I have returned all property, information and trade secrets belonging to all prior employers. I understand that any violation of this provision shall be grounds for my immediate termination, and could subject me to civil liability and possibly criminal penalties.


• No Conflicts: I understand that if hired, I may not hold other employment or engage in sales, investments or other activities that create a conflict of interest with my employment with the Company.


• Re-Application: This application for employment will remain active for 60 days, after which, if I wish to be considered for employment, I must submit a new application.
• By selecting "yes", I certify that I have read, understand and agree with the above statements.
   Yes  No

• If you have an existing resume please attach it before submitting your application:
  
  
  
  
  Please Enter the code shown above: