| General Information |
| *First Name: |
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| Middle Initial: |
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| *Last Name: |
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| *Address: |
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| Apartment/Suite: |
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| *City: |
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| *State: |
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| *Zip: |
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| Email: |
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| *Home Phone: |
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| *How would you like us to contact you? |
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| What position are you interested in? |
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| If you selected Store Manager Trainee above, will you relocate? |
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| What city and state location are you interested in? |
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| Do you prefer: |
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| Date Available: |
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(mm-dd-yyyy) |
| Hours Available: |
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| Pay Desired: |
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| *Have you ever worked for Stage Stores (Bealls, Palais Royal, Peebles, and Stage)? |
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| Do you have relatives or friends working for Stage Stores (Bealls, Palais Royal, Peebles, and Stage)? |
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| List any work related talent or skills and tell us why you want to work for Stage Stores: |
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| If you have missed more than 5 days from work during the last year, please explain here: |
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| Have you ever been convicted, plead quilty or no contest to, received a deferred adjudication, suspended sentence or accepted any other court related sentencing program for a crime? |
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*Have you ever been convicted of a crime other than a minor traffic violation:
(The existence of a criminal record will not automatically disqualify you from a job for which you are applying.) |
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| Have you ever been discharged (fired) from a job: |
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| Are you 21 years of age or older? |
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| Education |
| *What is the highest level of education you have completed? |
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| If you have a degree, what type of degree did you earn? |
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| Employment History |
| *Former/Current Employer: |
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| Address: |
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| Apartment/Suite: |
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| City: |
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| State: |
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| Zip: |
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| Phone: |
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| Type of Business: |
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| Employed From: |
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(mm-dd-yyyy) |
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| *Position Title: |
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| *Supervisor's Name: |
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| Salary Start: |
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| End: |
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| Description of Duties: |
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| Reason for Leaving: |
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| What were your primary accomplishments? Tell us about your former job and employer: |
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| Resume |
| If you would like to send your resume, you may cut and paste a text file: |
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