Job Application Applicant Information It is the policy of Anakeesta to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status. Applicant Name* First Last Home Address* City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCĂ´te d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRĂ©unionSaint BarthĂ©lemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTĂĽrkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweĂ…land Islands Country Phone Number*Email* Job Position Applied For* Desired hours (mark all that apply)* Full Time Part Time Summer Only Are you at least 18 years old?* Yes No Do you have reliable transportation?* Yes No Do you have a valid driver’s license?* Yes No Are you willing to work any shift, including nights, weekends and Holidays?* Yes No If no, please explain why.* If you are offered employment, when would you be available to begin work?* MM slash DD slash YYYY If hired, are you able to submit proof that you are legally eligible for employment in the United States?* Yes No Are you able to perform the essential job functions of the job position you seek with or without reasonable accommodation?* Yes No Have you ever been convicted of a felony or misdemeanor?* Yes No What were you convicted of?* Conviction Date* MM slash DD slash YYYY City Convicted In* State Convicted In* The existence of a criminal record does not constitute an automatic bar to employment unless relevant to the type of employment.Applicant Skills Check those skills that you have. List any other skills that may be useful for the job you are seeking and enter the number of years of experience.Skills* Customer Service Retail Experience Management Skills Computer Skills How did you hear about Anakeesta?*Tell us about your interests (sports, hobbies, other skills, accomplishments)*Why do you want to work at Anakeesta?*What are your career goals?* Applicant Employment History List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held. Then list and explain any gaps in employment.Employer Name Job DutiesReason For Leaving Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Employer Name Job DutiesReason For Leaving Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Employer Name Job DutiesReason For Leaving Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Applicant Education and TrainingMilitary Service* Yes No Branch Specialized Training Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer:Upload Your Resume/ Cover Letter Drop files here or Select files Accepted file types: pdf, docx, doc, Max. file size: 2 GB. Applicant Certification I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize Anakeesta to contact my former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. I realize that if offered employment, such employment is contingent upon passing a drug test provided by a third party at no cost to me. Further, if selected as an employee I agree to random drug/alcohol testing, for cause drug/alcohol testing, or post accident drug/alcohol testing. If at anytime I refuse to submit to a drug or alcohol test under Anakeesta policy, or otherwise fail to cooperate with the testing procedures, I will be subject to immediate termination. No manager, supervisor, or Employee of Anakeesta, LLC has any authority to enter into an agreement for any specified period of time or to make an agreement for employment other than at will. I HAVE CAREFULLY READ THE ABOVE CERTIFICATIONS AND I UNDERSTAND AND AGREE TO ITS TERMS AS STATED ABOVE.Applicant Name* Date* MM slash DD slash YYYY CAPTCHA Δ Share this page: