Dear Hearts Employment Application. Please complete all questions. Upon submitting application it will be emailed to the manager who will call you for an interview. If you have questions, you may send email to jeff@dearhearts.com. The stores open between April 1 and April 15.

Please answer all questions: For Security purposes, this form does not include Social Security Number. Please provide it at interview.

*Today's Date*
*Your Full Name, First, Middle, Last*
*Date of Birth*
*Home Street Address*
*Address (cont.)*
*City*
*State*
*Zip Code*
*Cell Phone*
*Home Phone*
*Email Address*
*Emergency Contact Person Name and Number*
*School or College*
Do you have your own transportation? yes or no
If no, How will you get to work?
*Current Grade Level in School or college*
*List any previous work experience here*
*Position Applying for, ie: counter help, manager*
*Which Dear Hearts Location are you applying for*
*Date Available to Start:*
*Days and Hours you ARE Available to work*
*Days and Hours NOT Available to work*
*Special Skills, Hobbies, Interests, Computers*
*List 3 Names and Phone Numbers for References:*
*If you were referred by someone, let us know who*