Application for Employment
Applicants are considered for all positions regardless of race, ethnicity, religion, gender, national origin, age, disability, sexual orientation, citizenship, marital or veteran status, or the presence of a non-job related medical condition or disability.

Please complete the entire application, even if you are submitting a resumé (upload a resumé after completing the application.)
Personal Information
First Name:   Last Name:  Middle Initial:  
Street Address:   City:  
State:   Zip:  Phone:  Email:  
Are you legally authorized to work in the United States?  Yes    No
Can you perform the essential duties of the job for which you are applying without an accommodation?  Yes     No
If you are under age 18, can you furnish a work permit?  Yes    No
Desired position:  Desired salary:  

Business Hours
Mon.-Fri.   7am-11pm
Sat.-Sun.   8am-9pm
All employees must work a Saturday or a Sunday!
Availability
Full-Time (36+ hours per week)    Part-Time    On-Call/Temp
Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday
Weekdays:    Earliest time available:    Latest time available:
Weekends:    Earliest time available:    Latest time available:
Minimum numbers of hours desired per week: Maximum number of hours per week desired:
Date available to start working:
How were you referred to us?  Online   Newspaper   Employee   On my own   Other

Education
High School:    Name: City & State:
College:    Name: City & State: Major:
Other:    Name: City & State: Major/Subject:
List certifications, scholarships, awards, honors received:

Indicate languages you speak or write fluently (English is presumed):

Have you been convicted of a misdemeanor or felony in the past 10 years? Yes    No
If yes, please explain:

Employment History
Please list your 3 most recent employers, starting with the most recent. Please complete this section of the application, even if you are uploading a resumeé.
Last or present employer
Company Name: Supervisor's Name:
Phone: Employed from (month and year): to: Salary:
Job title and description:

Reason for leaving:
Previous employer
Company Name: Supervisor's Name:
Phone: Employed from (month and year): to: Salary:
Job title and description:

Reason for leaving:
Previous employer
Company Name: Supervisor's Name:
Phone: Employed from (month and year): to: Salary:
Job title and description:

Reason for leaving:

Professional References (only professional references, not personal references)
Reference 1
Name: Company/Title: Phone:
Reference 2
Name: Company/Title: Phone:
Reference 3
Name: Company/Title: Phone:

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for dismissal. I authorize the references listed above to give Blooms Today (the Company) any and all information concerning my previous employment, including any other pertinent information they may have, personal or otherwise. In consideration of my employment, I agree to conform to the practices, rules, and regulations of the Company and my employment and compesation can be terminated at-will, with or without cause, and with or without notice, at any time, at the option of either the company or myself.