Complete Application Below All fields marked by * must be filled out. Use N/A if necessary. Location: Please select EastvaleSalesLos Angeles Position applying for: *E-mail: Select resume to upload: *Date (Eg.04/21/2013) *First Name *Last Name Middle Name Present Address *No. and Street *City *State *Zip Permanent Address (if different from present address) No. and Street City State Zip Cell Phone *Home Phone   Referred by   How did you find out about us? Indeed Linked In Other(please specify):       Are you a US Veteran? Yes No Education, Training and Experience High School *Institution Name *No. of years Completed Yes No *Did you Graduate?   *No. and Street *City *State *Zip College/University Institution Name No. of years Completed Yes No Did you Graduate? Degree No. and Street City State Zip Vocational/Business Institution Name No. of years Completed Yes No Did you Graduate? Degree No. and Street City State Zip Employment History List below all present and past employment starting with your most recent employer (last five years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume. *Name of Employer *Telephone No. *Type of Business *Supervisor's Name *No. and Street *City *State *Zip *Dates of Employment From: (Eg.04/21/2013) *To: (Eg.04/21/2013)     *Your Position and Duties(500 chars max) *Reason for Leaving *May we contact this employer for a reference? Yes No Name of Employer Telephone No. Type of Business Supervisor's Name No. and Street City State Zip Dates of Employment From: (Eg.04/21/2013) To: (Eg.04/21/2013)     Your Position and Duties(500 chars max) Reason for Leaving May we contact this employer for a reference? Yes No Note: Enter additional employment information if necessary. References List below three persons not related to you who have knowledge of your work performance within the last three years. First Name Last Name Telephone No No. and Street City State Zip Occupation No. of Years Acquainted First Name Last Name Telephone No No. and Street City State Zip Occupation No. of Years Acquainted First Name Last Name Telephone No No. and Street City State Zip Occupation No. of Years Acquainted Personal Information *Have you ever applied to or worked for K-Swiss, Inc. Company before? Yes No *If yes, when? *Do you have any friends or relatives working for K-Swiss, Inc. Company? Yes No *If yes, state name(s) and relationship: Name Relationship Name Relationship *Why are you applying for work at K-Swiss, Inc. Company? *If hired, would you have a reliable means of transportation to and from work? Yes No *Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.) Yes No If hired, are you able to provide document(s) stating you are authorized to work in the United States? Yes No Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? Yes No If no, describe the functions that cannot be performed. (Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.) Please Read Carefully, Initial Each Paragraph and Sign Below: *Initials   I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *Initials   I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release K-Swiss, Inc. Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. *Initials   I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or K-Swiss, Inc. Company, and that no promises or representations contrary to the foregoing are binding on K-Swiss, Inc. Company unless made in writing and signed by me and the company’s designated representative. *Initials   Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by K-Swiss, Inc. Company I am entitled to copies of any such public records obtained by K-Swiss, Inc. Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.   I waive receipt of a copy of any public record described in the paragraph above   Date (Eg.04/21/2013) Enter your name (Your IP address will be collected as proof of signature) *Date (Eg.04/21/2013) *Enter your name (Your IP address will be collected as proof of signature authorizing the Procurement of the Consumer Report and/or Investigative Consumer Report) Back Next

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