Hopkins Center Drug - Job Application

Thank you for your interest in employment with Hopkins Center Drug.

Please fill out the application below as fully as possible.

(Please submit online, or print and bring to Hopkins Center Drug. All employment applications will be reviewed by the store manager and filed for future openings)

Once our team has had a chance to look it over, someone from the store will be in contact with you.

Employment Application

Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status

Leave this empty:

General Information

* = required fields

Full Name: * Missing

Present Address: *

City: *

State: *

Zip Code: *

Phone Number: (no dashes) *

Email Address:

Position applying for: *

Date Available to start *

Select an hourly wage

$ per hour

Since you are applying for a Pharmacy Technician, please answer the questions below

* Are you registered?:
Yes No Missing

Are you certified?:
Yes No Missing

State Registered in: *

* Registration #:

Since you are applying for a Pharmacist, please answer the questions below

* Are you licensed?:
Yes No Missing

State Licensed in: *

* License #:

Schedule Availabilty

Select full or part time

* Are you looking for Full Time, Part Time, or any?

Full Time Part Time Any Missing

List hours available to work each day (eg. 4pm - 9pm)

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

*NOTE: Work schedules are based upon the needs of the business and may be subject to change on a weekly basis.

Pre-employment screening

* Are you willing to consistently show up on time as scheduled?

Yes No Missing

* Are you willing to respond to customer needs through clear, pleasant and respectful communication?

Yes No Missing

* Are you willing to perform many different tasks within the store during each shift?

Yes No Missing

* Are you willing to use a computer and learn to run a cash register?

Yes No Missing

* Are you willing to maintain store cleanliness, including cleaning counters, floors and restrooms?

Yes No Missing

* Do you have experience in a role requiring interaction with and fulfilling customer requests?

Yes No Missing

* Are you comfortable interacting with customers in a busy environment?

Yes No Missing

* If no, please explain why not Missing Explanation

* Have you ever been terminated or asked to resign?

Yes No Missing

* If yes, please explain why Missing Explanation

* Have you ever been counseled or disciplined for cash handling violations?

Yes No Missing

* If yes, please explain why Missing Explanation

* Were you referred to this role by a current Center Drug employee?

Yes No Missing

* If yes, who referred you? Missing Explanation

* Do you have any friends or relatives currently working at Center Drug?

Yes No Missing

* If yes, who and what is the relationship Missing Explanation

* Are you a citizen of the United States? (Proof of identity and eligibilty will be required upon employment)

Yes No Missing

* Are you authorized to work in the United States?

Yes No Missing

* Are you 18 years of age or older?

Yes No Missing

* Do you have a drivers license? (Required if you are applying for a position as a delivery driver)

Yes No Missing

* Do you have reliable transportation to work?

Yes No Missing

Education

Please provide the last school you attended

* School:

* Did you graduate:
Yes No Missing

* Grade or level completed:

Extracurricular activities:

Employment References

Current Employer

Company Name:

Position:

From (Month/Year):

To (Month/Year):

Supervisor's Name:

Supervisor's Position:

Phone Number (no dashes):

Previous Employer

Company Name:

Position:

From (Month/Year):

To (Month/Year):

Supervisor's Name:

Supervisor's Position:

Phone Number (no dashes):

Personal References (not former employers or relatives)

* Name:

* Occupation:

* Phone Number (no dashes):

Name:

Occupation:

Phone Number (no dashes):

Comments:

Disclaimer and Signature

IMPORTANT - READ BEFORE SUBMITTING

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Hopkins Center Drug to verify their accuracy and to obtain reference information on my work performance. I hereby release Hopkins Center Drug from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of Hopkins Center Drug. However, I further understand that neither the policies, rules, regulations of employment, or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration, and at will, and that either I, or Hopkins Center Drug may terminate my employment at any time with or without notice or cause.

* I agree with the terms of the application and wish to submit it to Hopkins Center Drug.