Employment Application

Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application.

We adhere to a policy of making employment decisions without regard to age, race, color, creed, religion, sex, national origin, marital status, disability/handicap, arrest/conviction record, sexual orientation and veteran status. We assure you that your opportunity with Mattress Express depends solely upon your qualifications.

Please do NOT utilize the “chat” feature to inquire about receipt of applications. Thank you.

First Name

Last Name

Street Address and/or Mailing Address

City

State

Zip

SSN

Home Telephone Number

Cellular Telephone Number

Position applying for

Hours:Full TimePart Time

Are you able to perform the essential functions of the position with or without accommodations? YesNo

Are You 18 Years of Age or Older?YesNo

(If Under 18, Please State Your Age)

Date Available for Employment

Min Salary Requirements

Do you have reliable transportation to work?YesNo

In case of an emergency, contact

Phone #

Employment Experience

Your present or most recent employer:

Company Name

Phone

Employed (date) from

to (date)

Ending Salary/ Rate

Supervisor Name

Work Performed

Reason for Leaving

Upload Resume

Previous employer:

Company Name

Phone

Employed (date) from

to (date)

Ending Salary/ Rate

Supervisor Name

Work Performed

Reason for Leaving

EDUCATION

High School

Univ./College

Major/ Degree

Military, Business Trade, Other

Major/ Degree

SPECIAL SKILLS, CERTIFICATES or PROFESSIONAL LICENSES

Summarize special job-related skills and qualifications from employment or other experience as well as any certificates or professional licenses that you hold.

Special Skills

The facts set forth in my application are true and complete. I authorize Mattress Express to investigate all statements contained in this application and hereby authorize my former employers to furnish all information pertaining to my work record. I hereby release my former employer from all liability on account of furnishing such information to Mattress Express. I understand that if employed, false statements, omissions or misleading statements on this application could lead to dismissal and agree that Mattress Express shall not be held liable in any respect if my employment is terminated because of such omissions or false or misleading statements.

I have read the disclaimer and give Mattress Express authorization to investigate my employment history, including the contacting of the employers listed above

I Agree