Question	Answer
Form Name	99 Cent Job Application
Form Length	2 pages
Fillable?	Yes
Fillable fields	135
Avg. time to fill out	27 min 34 sec
Other names	99 only application online, 99 employment application, 99 cent store online application print out pdf, 99 application

PERSONAL INFORMATION (please print)	Kindly fill out the application completely and give it to the receptionist or the
	store manager. Incomplete applications cannot be accepted.

__________________ _______________ _________					_____ -____-______			(_____) ___________ ________
Last Name	First Name		Middle Name			Social Security Number		Phone Number		Date
If under 18 years of age, can you provide proof of your ability to work?  Yes					 No	 NA	Are you legally eligible for employment in the US?			 Yes  No
Have you ever been convicted of a crime other than a minor traffic violation (Please note that in answering this question, 99 Cents Only Stores, LLC does
not request, and you should not provide, any information concerning any arrest or detention that did not result in a conviction, any referral to
or participation in any diversion programs, or any conviction from two years ago or earlier for a marijuana‐related offense that did not									Referred by:
involve the selling of marijuana.)?	 Yes  No		If Yes, please below.
									___Person ___________

Explain_____________________________________________________________________________________________									___Newspaper________
(A conviction is not an automatic bar to employment. Each case will be considered on its own merit)

_______________________________________		_____________		________________		__________	_________	_____________	___Walk-in___________
									___Other_____________
Present Address		Apt/Unit #		City		State	Zip Code	County
_______________________________________		_____________		________________		__________	_________	_____________
Previous Address		Apt/Unit #		City		State	Zip Code	County

EMPLOYMENT DESIRED (If applying for a retail hourly position, please note that availability of hours may vary and are thus not guaranteed)
		Do you have friends/relatives working at 99 Cents Only Stores, LLC?  Yes If so, who/where? _______________________  No
Position_________________________ Expected Wage $______per hour				Date Available_____________ Have you ever worked for 99 Cents Only Stores, LLC?  Yes  No
Applying for:  Full‐time	 Part‐time  Temporary					If so, when______________ where___________________
Sunday	Monday		Tuesday	Wednesday	Thursday		Friday	Saturday

Is there any reason why you would not be able to perform all of the job duties of the position you have applied for?						 Yes  No

Start Date	Salary/Hourly
End Date Current Employer (Name & Address)	Starting Pay/Ending Pay		Position	Duties		Reason for Leaving

	Salary	Hourly

	Starting $ ____ per hr
	Ending $ ____ per hr

Supervisor’s Name ____________________________ Phone Number _____________________					May We Contact? Y N

Start Date	Salary/Hourly
End Date Employer (Name & Address)	Starting Pay/Ending Pay		Position	Duties		Reason for Leaving

	Salary	Hourly

	Starting $ ____ per hr
	Ending $ ____ per hr

Supervisor’s Name ____________________________ Phone Number _____________________					May We Contact? Y N

_______________________________	________________________________
Signature	Date

OFFICE USE ONLY:
Hire for Position of _________________ First Day of Work _____________ Pay Rate $____._____		 Hourly /  Salaried
 Full Time /  Part Time	Store/Department _____________________________	Permit Needed: Y N
Signature of Interviewer ________________________ Date _____________________		EOE	rev. 10/13

99 Cent Job Application – Fill Out and Use This PDF

99 Cent Job Application PDF Details