RETL400201 - FRONT END DEPARTMENT

Mar 23, 2020

Personal Information
Candidate Name: Denman, Ezra

Be sure to click the arrow at the bottom of the page to proceed to the next step.

Personal Information

First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ezra
(Legal Name as it appears on your SSN Card)
Middle Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Riot
(Legal Name as it appears on your SSN Card)
Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Denman
(Legal Name as it appears on your SSN Card)
Preferred First Name . Ezra
.....................................................
Preferred Last Name .
.....................................................
Email Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ezra.Riot.Denman@gmail.com

Address 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3605 steck ave

Address 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Austin
Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . United States
State/Province ** Texas
(For US or Canada, State/Province is Required)
County **
For US, County is Required Travis
If county is not displaying, please reselect the country and state dropdowns.
Zip/Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78759
Primary Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(512) 230-3827
(Please use format xxxxxxxxxx)
Secondary Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Please use format xxxxxxxxxx)

General Information

Are you legally able to work in the U.S.? Yes

If no, please describe work authorization status **
Salary Requirements?
$10,000 - $20,000
Please select salary range from drop down below.
Would you require sponsorship now or at any time in the future? No

Are you under the age of 18? . I am under 18

.....................................................

If under 18, please enter your age ** 16

Do you have any relatives or members of your household employed by the

No
company in the location to which you have applied?
(If YES, the Name, Relationship, Work Location and Position is required.)

Name **
Relationship **
Work Location **
Position **

Availability

Your availability will impact the positions for which you are selected and the number of hours you are scheduled. However, the Company provides reasonable accommodations for those with disabilities and
those with sincerely held religious beliefs, so it is not necessary for you to exclude from your availability the time needed for religious observance or disability accommodations.
Date Available for Work . 03/23/2020
.....................................................
Total hours available per week . 30
.....................................................
What is  your availability? Anytime
For each day of the week, please include earliest start time and latest end time including AM and PM (ex. 1PM -- 6PM)
Monday ** 9am - 9pm
Tuesday ** 9am - 9pm
Wednesday ** 9am - 9pm
Thursday ** 9am - 9pm
Friday ** 9am - 9pm
Saturday ** 9am - 9pm
Sunday ** 9am - 9pm

Accommodations

You may request an accommodation during the application, interview and hiring process by contacting the Hiring Manager, Recruiter or the Human Resources Department for the Division or location where
you are applying or by calling the Employee Service Center at 1-888-255-2269. Requests for accommodation during employment may be made to the Store Director, Location Manager or Human Resources. If
you believe you have been wrongly denied an accommodation, you may contact Human Resources or Employee Relations for the Division or call the tollfree Ethics Hotline at 855-673-1084.
Professional LIcenses
Candidate Name: Denman, Ezra

Credential Reference

Please provide the credentials for the State in which you are applying.

Are you applying to a position in the Pharmacy Department which requires a

pharmacy license? *
 
No
Please note: If applying for a Pharmacy Clerk in Iowa or Washington, a
pharmacy license is required. If applying for a Pharmacy Clerk in any other
state, a pharmacy license is not required.

Professional License 1
License Type**
License Expiration**
License Number**
Country**
State**

On any pharmacy license (e.g. pharmacist, intern, technician) held in any

state, have you received any disciplinary action or had your license
suspended or revoked?**
If Yes, please explain in detail.**
Acknowledgement
Candidate Name: Denman, Ezra

Release and Acknowledgement

Please read the important information below about your application. 

1. I authorize the employers and references listed to provide the Company with information about my previous employment and any other information they may have (except information that
cannot be obtained as a matter of law). I release all parties and persons, including the Company, from any and all liability for any damages for seeking or providing this information, consistent
with local, state and federal law.

2. I understand that employment is conditioned upon passing a post-offer, pre-employment drug screening test and background check. I also understand for certain positions it may be
necessary for me to provide proof that I am 18 or older and/or to pass a post-offer medical examination, if applicable. If I am under the age of 18, I understand that I will be required to provide
a work permit or other required work authorization form if required by state law.

3. I understand that any false statement or omission during the interview, on this application or made by me as part of the hiring/onboarding process may prevent me from receiving an offer of
employment, may result in the withdrawal of an employment offer, or may result in my discharge from employment if I am already employed at the time the false statement or omission is
discovered.

4. I understand that on or before the first day of work, I must provide satisfactory documentation that establishes my identity and eligibility to work in the U.S.

5. I understand that if I am employed by the Company, my employment is at will and for no specific term unless otherwise provided by an applicable collective bargaining agreement or written
employment agreement executed by the CEO or his/her designee.

6. I understand the Company, in its sole discretion, may change its existing hiring practices and policies at any time with or without notice to me.

7. I understand that this application for employment will be active up to 90 days and after 90 days, it will be necessary for me to reapply.

By eSigning, I understand that I am certifying I have read, understand and agree to the information in the Release/Acknowledge and I agree that my electronic signature will have the same authority
and legal effect as my original signature.
Please let us know if you received assistance completing this application. Completed and Signed by Applicant
Legal First Name: Ezra Legal Last Name: Denman
Your name as it appears above: Ezra Denman
Accepted
If you choose to Decline, your application will not be considered at this time. 
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mar 23, 2020 07:48 pm