Application for Employment

Application for Employment

TODAY'S DATE ___________________________

www.tjxjobs.com

FULL NAME

__________________________________________________________________________________________________

Last

First

Middle

CURRENT ADDRESS
	_______________________________________________________________________________________

Street & Number

_______________________________________________________________________________________

City

State

Zip Code

PREVIOUS ADDRESS

_______________________________________________________________________________________

Street & Number

_______________________________________________________________________________________

City

State

Zip Code

PREFERRED NAME OR NICKNAME

TELEPHONE NUMBER

E-MAIL ADDRESS

SOCIAL SECURITY NUMBER

Have you ever applied to T.J. Maxx, Marshalls, HomeGoods, A.J. Wright, or The TJX Companies, Inc. before? o Yes o No

If yes, give dates: __________________________________

Have you ever worked for T.J. Maxx, Marshalls, HomeGoods, A.J. Wright, or The TJX Companies, Inc. before? o Yes o No

If yes, month and year: ______________________________ Location: ______________________________

If hired, and you are under 18, can you furnish a work permit? o Yes o No o I am over 18

If hired, can you provide proof of identity and authorization to work in the U.S.? o Yes o No

Indicate division you are applying to:

o T.J. Maxx

o Marshalls

o HomeGoods

o A.J. Wright

Position you are applying for:________________________

Date available for work:_____________________________

Total hours available per week:_______________________

From To
From To

Are there any days or hours that you are unable or unwilling to work? Please specify: ______________________________________________

__________________________________________________________________________________________________________________

Are you willing to relocate?_________________ If so, where?___________________________________ Will you travel?________________

How were you introduced to The TJX Companies, Inc.?

o Employee Referral

o Newspaper ad

o Walk in

o College/University

o Dept. of Employment

o Community Organization

o Web Site

Are you acquainted with anyone who works for The TJX Companies, Inc.? o Yes o No

Name:

We are an equal opportunity employer and do not discriminate against any applicant because of race, color, religion, sex, age, national origin, disability, sexual orientation, marital status, or any other legally protected group.

Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer. All information must be included, even if you are attaching a resume. Please attach an additional sheet if necessary.

Employer

Work Performed

Address

Telephone Number(s)

Job Title

Supervisor

Reason for leaving

Dates Employed

From

Hourly Rate/Salary

Starting

Final

Explain any time between jobs:

Employer

Work Performed

Address

Telephone Number(s)

Job Title

Supervisor

Reason for leaving

Dates Employed

From

Hourly Rate/Salary

Starting

Final

Explain any time between jobs:

Employer

Work Performed

Address

Telephone Number(s)

Job Title

Supervisor

Reason for leaving

Dates Employed

From

Hourly Rate/Salary

Starting

Final

Explain any time between jobs:

Employer

Work Performed

Address

Telephone Number(s)

Job Title

Supervisor

Reason for leaving

Dates Employed

From

Hourly Rate/Salary

Starting

Final

List any special training or skills (cashier, bookkeeping, general warehouse, maintenance, foreign language fluency, etc.) relevant to the position for which you are applying.

___________________________________________________________________________________________________________________

Please tell us of any experiences, skills, or qualifications, which you feel would qualify you for work with The TJX Companies, Inc.

___________________________________________________________________________________________________________________

CIRCLE HIGHEST GRADE COMPLETED:

ELEM 6 7 8

HIGH 9 10 11 12

COLLEGE 13 14 15 16 17 18 19

HIGH SCHOOL____________________________________________________________________________________________________

City

State

DIPLOMA OR GED: o Yes o No

COLLEGE: (List all whether or not degree was obtained)

NAME

LOCATION

MAJOR FIELD
OF STUDY

MINOR FIELD
OF STUDY

DEGREES

Additional job-related seminars, short courses, workshops or other educational experiences: _________________________________________

___________________________________________________________________________________________________________________

Academic honors or special recognition* __________________________________________________________________________________

Extra curricular activities* _____________________________________________________________________________________________

Please list any job-related clubs, professional societies, or other associations to which you belong.* ____________________________________

___________________________________________________________________________________________________________________

Do you have any objection to our contacting your previous schools? o Yes o No

*You may omit those which may indicate your race, religious creed, color, national origin, ancestry, sex, age, or other status protected by applicable law.

Give name, address and telephone number of four references who are not related to you:

(Supervisor) _________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

(Supervisor) _________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

(Co-worker) _________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

(Personal) ___________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

Have you been convicted of a felony in the past five (5) years? o Yes o No

If yes, give details including date, location (city), nature of offense and disposition _________________________________________________

____________________________________________________________________________________________________________________

NOTE: A conviction record will not necessarily be a bar to employment. Applicants with a sealed record on file may answer "no record" to any inquiries about criminal charges.

Have you ever taken any merchandise, money, or property from an employer? o Yes o No

If yes, give details ____________________________________________________________________________________________________

____________________________________________________________________________________________________________________

California applicants only: Have you ever been convicted of a felony? [NOTE: You need not identify convictions that have been sealed, expunged, dismissed, or otherwise eradicated by statue or court order, any conviction for a marijuana offense if the conviction is more than two years old, or any information pertaining to referral to and participation in any pre-trial or post-trial diversion program.] o Yes o No
(Such conviction may be relevant if job-related, but does not necessarily bar you for employment.)

If "YES", please explain: ____________________________________________________________________________________________________

Massachusetts applicants only: Applicants may respond "No Record" if they have been arrested but never convicted; have not been convicted within five years preceding their application; and have on their records only misdemeanors more than five years old; have only one conviction for simple assault, a traffic offense, or drunkenness; or have a sealed criminal record on file with the commissioner of probation. In addition, applicants may answer "No Record" with respect to any inquiry relative to prior arrests, court appearances and adjudications in all cases of delinquency or a child in need of services which did not result in a complaint transferred to the Superior Court for criminal prosecution.

Connecticut applicants only: Applicants for employment are not required to disclose the existence of any arrest, criminal charge, or conviction for which the records have been erased in accordance with the provisions of Connecticut State Law. Records subject to erasure are records pertaining to a finding of delinquency, an adjudication as a youthful offender, a criminal charge that has been dismissed or nolled, a criminal charge for which a person has been found guilty, or a conviction for which a person received an absolute pardon. Any person whose criminal records have been erased in accordance with the provisions of Connecticut State Law shall be deemed to have never been arrested within the meaning of Connecticut General Statutes and may so swear by oath.

READ CAREFULLY BEFORE SIGNING

I certify that the statements and information furnished by me in this application are true and correct. I understand that omitted, false or misstated statements on this application are grounds for refusal to hire, or dismissal, at any time the company becomes aware of the omitted, falsified, or misstated information. In consideration of my employment, I agree to conform to the rules and regulations of your company and acknowledge that my employment and compensation can be terminated, with or without cause, and with or without notice at any time, at the option of either the company or myself. I further understand that no policy, benefit, or procedure contained in any employee handbook creates an employment contract for any period of time, and no terms or conditions of employment contrary to the foregoing should be relied upon, except for those made in writing by a designated officer of the Company.

I agree and hereby authorize The TJX Companies, Inc. to conduct a background inquiry to verify the information on this application and any company form completed by me. I authorize all previous employers or other persons who have knowledge of me or my records, to release such information to The TJX Companies, or their agents. I authorize The TJX Companies, Inc. to conduct consumer credit report inquiries as a result of my employment or at any time during my employment with The TJX Companies, Inc. I hereby release those companies and persons and The TJX Companies, Inc. from all claims or liabilities whatever that may arise by such disclosures or such investigation.

Massachusetts applicant's only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

MARYLAND APPLICANT'S ONLY: I ACKNOWLEDGE THAT I HAVE RECEIVED NOTIFICATION THAT UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.

My signature certifies that I have read and agree with the above statements.

Date of Application ______________________________

Signature of Applicant ____________________________________________

Please bring completed application to your local store