Personal Information
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email Access?	Yes No
Email Address:
Do You Have Internet Access?	Yes No
Do You Have a Printer?	Yes No
Do You Digital Camera?	Yes No
Please indicate any experience you may have:
Please indicate any background information that you feel is relevant:
Please indicate the days and hours that you are available:
Are you interested in a full-time opportunity?	Yes No
Are you interested in a part-time opportunity?	Yes No
Are you willing to travel?	Yes No
Please list Kohl's stores within 15 minutes of your home:
Where did you hear about Merchandise Management Company?:
Employment History
Employer:
Telephone:
Address:
Contact:
Dates Employed:
Salary:
Description of Duties:
Reason for Leaving:
Employer:
Telephone:
Address:
Contact:
Dates Employed:
Salary:
Description of Duties:
Reason for Leaving:
Employer:
Telephone:
Address:
Contact:
Dates Employed:
Salary:
Description of Duties:
Reason for Leaving:
Education:
High School:
Dates Attended:
Graduated?	Yes No
College/Trade/Business School?
Dates Attended:
Graduated?	Yes No