Midwest Cash/Pay Day Cash Application

NOTICE TO APPLICANTS: This application in no way guarantees a job or interview with our business. You may be asked to fill out a more deatailed application for further consideration for employment with our business. If called into our office you will be given a math and typing test to determine your apptitude for positions offered.

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human resources Department.

You must be 18 years or older to work at our business. You must be able to make valid contracts and sell guns, so this is a necessary requirement.

Midwest Cash/Pay Day Cash does not discriminate on the basis of gender, race, color, national origin, religion, age, disability, sexual orientation, marital status or ancestry in any of its policies, practices, procedures and employment.

*** NOTE: Use "TAB" not "ENTER" when filling in the boxes. If you hit "ENTER" it will close & send the application. ***
Today's Date Position

  Personal Data
First Name MI Last Name
SS# Email
Is there another name in which educational and/or prior employment records may be listed? No Yes
Other Name
Address City State
Zip Telephone # Other Phone #
Date available for employment Best Time to Call
Is there any reason known to you why you might be unable to perform consistently and promptly the duties of the job for which you are applying? No Yes
If yes, please explain.
Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Have you ever pled "guilty" or "no contest" to, or been convicted of a felony? Yes No
If convicted of a felony, please explain.
Are you legally eligible for employment in this country? Yes No

Referral Source
(Please check a category and name the source.)
Walk-in Employee
Advert. Our Website
Other Internet School
Job Fair Staffing Agency
Gov. Agency Other

  Education
  Name and Location Course of Study Years
Completed		 Certificate, Diploma
 or Degree
High School or Equivalent
Postsecondary Vocation School
College or University
Other Education/Special Training/
Military Schools

  Employment History
  (Current or most recent job first, then previous jobs in order)
Company Name Dates
Address
Beginning Pay Rate Final Pay Rate
Supervisor Business Phone
May we contact your supervisor/employer? Yes No May we contact you at work? Yes No
Job title and duties
Company Name Dates
Address
Beginning Pay Rate Final Pay Rate
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties
Company Name Dates
Address
Beginning Pay Rate Final Pay Rate
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties
Company Name Dates
Address
Beginning Pay Rate Final Pay Rate
Supervisor Business Phone
May we contact your supervisor/employer? Yes No
Job title and duties

Explain any gaps in employment, other than those due to personal illness, injury or disability.

  References
Please list three professional references that have knowledge of your professional experience and who are in a position to evaluate your ability to perform the job that you are applying for.
Name Occupation Address Telephone
By clicking on "submit application" button below; you are electronically signing and certifying to us that the information you have provided is true, complete and correct to the best of your knowledge. Furthermore, you are authorizing us to contact, interview and verify information from all references you have listed (employers, educational facilities and personal references) for use in determining your eligibility for hire with our company.
To send your application to us, hit the "Submit Application" button above.
WARNING! The "Reset Application" button clears all of the data you've entered.