W Harris G.S.C., Inc.

W Harris G.S.C., Inc.

APPLICATION FOR EMPLOYMENT

An Equal-Opportunity Employer

INSTRUCTIONS (Please read before completing the application)

Thank you for your interest in employment at W Harris G.S.C., Inc. If you meet the
minimum qualifications for positions that are currently available, your application will be
circulated to the appropriate department(s) for review. If there is an interest in your
qualifications, we will contact you to arrange an interview.
Please follow the directions below when completing your application; incomplete applications cannot be
processed.

1. Complete all blanks thoroughly and neatly in your own handwriting in blue or black
ink. Please do not type. Some questions require "yes," "no," or "none" answers. Do
not answer with "NA" or "see resume." If you are interviewed, you will be required
to provide proof of photo identification.
2. List ALL of your employers in chronological order beginning with the most recent.
Include all full-time, part time, summer, and temporary employment, along with
periods of unemployment and continuing education. Leave no gaps longer than a
one-month period. Do not indicate "see resume." If necessary, you may attach
additional sheets.
3. Military personnel should provide a DD214 -or-evaluations for the last two years
served. Please provide copies. Original documents cannot be returned.
4. Please be sure to complete the entire application even if you are attaching a
personal resume.
5. If requested we will provide assistance in completing the application form.
I am unaware of any engagements that will interfere with my work schedule for the
next 12 months.
Shannon Morgan McEnery
Signature______________________________

9/17/2011

Date_________________

W Harris G.S.C., Inc.

Office use only:

1. Did Candidate withdrawFOR
at any point?
APPLICATION
EMPLOYMENT
2. Position that was open?
W
HARRIS G.S.C., INC., Inc. is an equal opportunity employer and does not discriminate on the basis of race, religion,
color,
national
origin,
age, sex, gender, disability, sexual preference, veteran or any other characteristic protected by law.
3. Meets
minimum
requirements?
If requested we will provide assistance in completing the application form.

INTRODUCTORY INFORMATION:
Name:

Shannon M McEnery
____________________________________________________

Date:

9/17/2011
_______________________

15 Windy Hill Dr
Address: _______________________________________________________________________________________
City:

Newport
_____________________
State:

PA
_______

17074
Zip: __________

Phone:

717-567-3315
_________________

APPLICANT QUESTIONS:

Carlisle Barracks
Job location applying at: _________________________
Are you aware of any engagements that will interfere with your work in the next 12 months?
Position applying for:

Stocker
_______________

Wage desired:

16.05
___________

__Yes

Date Available:

If hired, can you provide documents required to establish your eligibility to work in the U.S.?
Do you meet our states minimum age requirement for work?

__

__

__No
9/18/2011
_________

Yes __ No
Yes __ No

PA Careerlink Website
How were you referred to W HARRIS G.S.C., INC.?_______________________________________________
Have you previously worked for the company?

__ Yes
__ No

Have you ever been convicted of a criminal offense? If so, state nature.

__ Yes
__ No

If yes, please explain in detail on a separate piece of paper and include the date of final disposition of the case and the
nature of the offense. This information will not necessarily disqualify you from employment but false or misleading
information will. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation
will be taken into account.

MILITARY EXPERIENCE:
List experience and special education received in the military:
Branch of Service:

_________________________________

From: __________

To:

___________

Rank/Type of Service: ____________________________________________________________________________

Job-Related Training/Experience: ____________________________________________________________________
RECORD OF EMPLOYMENT:
List positions starting with most recent:
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Toms Gulf
Employer: _____________________________________________

Address:

Telephone:

717-834-9446
_____________________________

7 Main St Duncannon,PA 17020

________________________________________________________________________________________

Cashier
Melinda Donnelly
Position Title: __________________________________
Supervisor: ________________________________________

07/2009
Start Date: _________

10/2010
Date Left: __________

8.00
8.15
Beginning Salary: __________
Ending Salary: __________

Duties:

register, customer service, balance cash drawer, stock shelves, clean sales floor
________________________________________________________________________________________

Reason for Leaving:

my restricted hours at the time did not meet the employers needs.
______________________________________________________________________________

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Aeropostale
Employer: _____________________________________________

Address:

Telephone:

631-208-3112
_____________________________

Tanger Mall Outlet Riverhead, NY 11951

________________________________________________________________________________________

Sales Associate
Michelle Gonzalez
Position Title: __________________________________
Supervisor: ________________________________________
10/2007
Start Date: _________
Duties:

12/2007
Date Left: __________

8.50
8.50/
Beginning Salary: __________
Ending Salary: __________

register, customer service, floorsets, stock and clean sales floor.

________________________________________________________________________________________

Reason for Leaving:

moved out of state.

______________________________________________________________________________

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

The Childrens Place

Employer: _____________________________________________

Address:

Telephone:

631-369-6602
_____________________________

Tanger Mall Outlet Riverhead, NY 11951

________________________________________________________________________________________

Sales Associate
Yvette Roosa
Position Title: __________________________________
Supervisor: ________________________________________

07/2006
Start Date: _________
Duties:

05/2007
Date Left: ___________

7.50
Beginning Salary: _________

Ending Salary:

7.71
_________

regsiter, customer service, floor sets, clean and stock sales floor.
________________________________________________________________________________________

Reason for Leaving:

hours were cut.

______________________________________________________________________________

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

WORK-RELATED REFERENCES: (Do not include relatives)

Name

Occupation

Years Known

Contact Information

christopher auditore
1. ____________________

mechanic
_________________

5
_____________

631-901-9504
___________________________________________

karen correira
____________________

purchasing assistant
_________________

20
_____________

717-365-3395
___________________________________________

3. __________________

_______________

____________

_______________________________________

2.

STATEMENT (Please read this statement carefully before signing this application):
I understand that employment with W HARRIS G.S.C., INC., Inc. (the Organization) is at-will, meaning that I or the
Organization may terminate my employment at any time, or for any reason consistent with applicable state or federal law.
I authorize the Organization to conduct a thorough background investigation of my work and personal history, and verify
all data given on this application and during interviews. I hereby release the Organization, and its representatives or
agents, from any liability that might result from such an investigation. I authorize all individuals and firms named to
provide any requested information and release them from all liability for providing the requested information.
I understand that the Organization may require the successful completion of a drug and/or alcohol test as a condition of
employment.
I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for
employment, I must submit a new application. I certify that all the statements in this completed application are
true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to
hire.

Shannon McEnery

09/17/2011
Signature of Applicant: ___________________________________ Date Signed: ________________________

EQUAL EMPLOYMENT OPPORTUNITY (EEO)

VOLUNTARY SELF-IDENTIFICATON FORM
Qualified applicants are considered for employment without regard to race, religion, sex, national origin, age, marital status, sexual
orientation, veteran status, disability, or other protected characteristic.
The employer is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws
and regulations. In order to comply with these laws, the employer invites employees to voluntarily self-identify their race or ethnicity.
Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information
obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and
regulations, including those that require the information to be summarized and reported to the federal government for civil rights
enforcement. When reported, data will not identify any specific individual.
This detachable form will be kept in a confidential file separate from your application for employment.
Name (Last, First, MI):

McEnery, Shannon M
___________________________________________________________________

Street Address:

15 Windy Hill Dr
___________________________________________________________________

City, State, Zip Code:

Newport, PA 17074
___________________________________________________________________

Position Applied For:

Stocker
________________________

Date Applied:

09/17/2011
___________

Gender Identification (check one)

____

Female

____

Male

Race/Ethnic Identification (check one):

____
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or
origin regardless of race.
If you did not check Hispanic or Latino above, please select one of the following race/ethnic identifications.

White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or
____
North Africa.
____

Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.

____
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
____
Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands,
Thailand, and Vietnam.
____
American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of
North and South America (including Central America), and who maintain tribal affiliation or community attachment.
____

Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.

_____

Decline self-identification

Shannon M McEnery

_________________________________________________
Applicants Signature

09/17/2011
__________________
Date