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Rally Stores, Inc. Online Application

Thank you for your interest in Rally. This application is for reference purposes only. Candidates for employment will be asked to complete a formal application prior to being hired. Federal, State and Local laws prohibit discrimination based on race, color, sex, religion, national origin, ancestry, age, disability, marital status or other legally protected status.

Prior to hiring, all employee candidates are required to submit a drug test and background check.
Rally Stores, Inc. is an equal opportunity employer.

Last Name:

First Name:

Middle Initial:

Social Security Number:

Email Address (Optional):

Address:

City:

County:

State:

Zip Code:

Phone Number:

Best Time to Call to schedule and interview or obtain additional information:

Morning

Afternoon

Evening

I am:

over 18

Under 18

If under 18 can you provide the necessary work certificate at the time of employment?

Yes

Have you ever been convicted of a crime other than a traffic violation?

Yes

If Yes, give all dates and reasons for conviction (a conviction will not necessarily disqualify you from the job)

Were you ever employed by Rally?

If Yes, what location?

Yes

Dates of Employment:

Reason for leaving:

from

Tell us about your Availability:

Days and hours are subject to change. Rally can not guarantee that employees will be assigned to desired hours.

Date available to begin work:

Weekends

Yes

1st Shift (6am-2pm)

Yes

Weekdays

Yes

2nd Shift (2pm-10pm)

Yes

Holidays

Yes

3rd Shift (10pm-6am)

Yes

Full-Time

Part-Time

Day	From	To
Sun
Mon
Tues
Weds
Thurs
Fri
Sat

Education

Please check all which apply:

Graduated High School

Attended College

2-Year Degree

4-Year Degree

Other Educational/Technical Schooling

List

Other special training, certificates, licenses, and skills (PC Software, Equipment, or Machine Operation, Languages, etc.)

List

Employment History (start with your most recent job)

If currently employed, may we contact your employer?

Yes

Company Name	Your Job	Last Pay Rate

Address	City	State

Zip Code	Phone #	Supervisor's Name

Dates Employed
from	to
Reason for Leaving: (check all that apply)
Resigned with noticeResigned without noticeTermination
Other
To the best of your knowledge, would this employer rehire you?
YesNo

Company Name	Your Job	Last Pay Rate

Address	City	State

Zip Code	Phone #	Supervisor's Name

Dates Employed
from	to
Reason for Leaving: (check all that apply)
Resigned with noticeResigned without noticeTermination
Other
To the best of your knowledge, would this employer rehire you?
YesNo

PLEASE READ CAREFULLY
THIS IS NOT AN EMPLOYMENT AGREEMENT OR CONTRACT.
However, by submitting this form you are agreeing to the following:

I certify that the information I have provided on this employment application is true and correct, and that no attempt has been made to conceal pertinent information. I understand that if any information given by me in this application is proven to be false or misleading, I will not be eligible for employment. If accepted for employment, I understand that the use of illegal drugs is prohibited and that any offer of employment is contingent upon satisfactory results of any required drug test and background investigation.

Thank you for applying with Rally! Your application will remain active for 90 days and remain on file for 1 year. We will notify you if a position that matches your qualifications becomes available. Again, we appreciate your interest in Rally.