The following questionnaire will ask you several questions about your experiences, your thoughts, and the way you would handle certain work scenarios. Please provide your best honest answer.

Have you ever been convicted of a felony crime or theft-related misdemeanor within the last 5 years? Yes  No
If you answered “yes” to the previous question, please explain.
Have you ever been dismissed or forced to resign from any employment? Yes  No
If you answered “yes” to the previous question, please explain.
How many years of experience do you have working in retail or in customer service?
Please describe that experience:
Are you willing to work a flexible schedule including evenings, weekends, holidays, and overtime as requested? Yes  No
If you answered �No� to the previous question, what type of schedule are you interested in? (check all that apply)* Full-Time, with overtime

Full-time, no overtime

Part-Time, less than 30 hours

Part-Time, less than 20 hours

No Evenings

No Weekends

No Holidays

Have you ever taken merchandise from a previous employer without paying for it? Yes  No
If you saw someone you knew taking merchandise without paying for it, what would you do?
If you saw someone you didn�t know taking merchandise without paying for it, what would you do?

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