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
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:



REMOTE AGENT READINESS CHECKLIST

Please select yes or no for the following questions:
  1. Yes No -- Do you have a private workspace in your house with a door, where ambient noise can be minimized during work time?
  2. Yes No -- Do you have or can you get an office space with a desk, a PC, phone with mute/hold/conference, a headset outlet and a headset?
  3. Yes No -- Do you have a land phone line that can be dedicated to work-related calls?
  4. Yes No -- Do you have a separate phone line or cell phone that can be dedicated to contact center calls?
  5. Yes No -- Are you technically capable of setting up and installing hardware and software required for your job (i.e. setting up an instant message account, downloading an application from the internet, changing an IP address, etc.?
  6. Yes No -- Do you have a reliable personal computer that meets the company's defined system requirements?
    • Operating System: Windows XP or later (in native Intel or AMD environment)
    • Web Browser: Internet Explorer version 7 or later
    • RAM: 800MB or more
    • Connection Speed: At least 128Kbps
    • Processor Speed: 1.5Ghz or greater (single processor), 700Mhz or greater (dual/quad processor or dual/quad core systems)
  7. Yes No -- Do you have a broadband/high speed internet connection?
  8. Yes No -- Can you commit to working a minimum of 25 hours per week?
  9. Yes No -- Are you willing to train for the position via online course materials and phone/webinar sessions?
  10. Yes No -- Have you ever participated in an online training program?
  11. Yes No -- Are you a quick and accurate typist who is comfortable communicating with a supervisor via chat?
  12. Yes No -- Have you purchased items on the internet in the past year through a web order entry process?
  13. Yes No -- Do you have any experience working at home for an off-site or remote manager?
  14. Yes No -- Are you a highly motivated self-starter who enjoys working by yourself?

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 compensation 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.