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					APPLICATION FOR EMPLOYMENT - HAWAII
                                           PLEASE PRINT
   700 N. Nimitz Hwy, Honolulu, HI 96817 Phone (808) 524-3966 Fax (808) 533-6809
                                                                      The Store of Hawaii
                                                            DATE OF APPLICATION _____/_____/_____
REFERRAL SOURCE: (circle one) Newspaper Ad/ Walk-In /Internet/ Employment Agency/ Employee/ Job Fair/ Other
Name of Referral Source (list name of employee if referred by Hilo Hattie employee)_______________________________________________
POSITION APPLYING FOR: _______________________________________________________________

 NAME: (last)                                                (first)                                    (middle)

 ADDRESS:
 PHONE #:                                                              CELL/BEEPER/OTHER #:
 SOCIAL SECURITY #:                                              DATE AVAILABLE TO WORK:
 SALARY DESIRED: $                               TYPE OF EMPLOYMENT DESIRED: Full-time/ Part-time/ Temp./ Seasonal
AVAILABILITY: (PLEASE LIST TIME & DAYS AVAILABLE BELOW)
                  SUNDAY          MONDAY           TUESDAY         WEDNESDAY         THURSDAY         FRIDAY         SATURDAY
  HOURS

If you are under 18 and it is required, can you furnish a work authorization? YES ____ NO ____
Are you legally eligible for employment in the USA? YES ____ NO____
Have you been employed or known by another name? YES _____ NO_____ If so, what other name: __________________________
Have you ever been employed by Hilo Hattie before? YES ____ NO ____
If YES, give dates of employment, job title & location _______________________________________________________
 (LIST ALL CURRENT & PAST EMPLOYMENT EXPERIENCE STARTING WITH MOST RECENT)

 EMPLOYER:                                                     JOB TITLE:
                                                               Hourly
  Dates Employed       From:               To:                                       Start:            End:
                                                               Rate/Salary
 Duties/Responsibilities:

 Immediate Supervisor Name/ Title/ Phone #:

 May we contact for Reference:      YES       NO               Reason for Leaving:

 EMPLOYER:                                                     JOB TITLE:
                                                               Hourly
  Dates Employed       From:               To:                                       Start:             End:
                                                               Rate/Salary
 Duties/Responsibilities:

 Immediate Supervisor Name/ Title/ Phone #:

 May we contact for Reference:      YES       NO               Reason for Leaving:

 EMPLOYER:                                                     JOB TITLE:
                                                               Hourly
  Dates Employed       From:               To:                                       Start:             End:
                                                               Rate/Salary
 Duties/Responsibilities:

 Immediate Supervisor Name/ Title/ Phone #:
 May we contact for Reference:      YES       NO               Reason for Leaving:

Comments (Including explanation of any gaps in employment)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
       (List special training, skills, languages, and licenses, certificates that may qualify you as being able to perform job-related functions of the position applying for.)


            EDUCATIONAL BACKGROUND                                                            SKILLS/LANGUAGES & QUALIFICATIONS:
 HIGH SCHOOL:
 COLLEGE:
 HIGHEST GRADE COMPLETED:
 DIPLOMA/DEGREE:

REFERENCES (List name and phone number of three business/work references who are not related to you and are not previous
supervisors. If not applicable, list three school or personal references who are not related to you.)
                   NAME                                                        ADDRESS                                              PHONE                    YEARS KNOWN




LIST ANY ADDITIONAL INFORMATION YOU WOULD LIKE US TO CONSIDER. (Trade, business, or civic
associations. U.S. military service, special accomplishments, publications, awards, etc.) (Exclude information that would
reveal sex, race, religion, national origin, age, color, disability or other protected status)

EMERGENCY CONTACTS
 Name:                                                                                                    Phone # (Day):
 Address:                                                                                                 Phone # (Night):
                                                                                                          Relationship:
 Name:                                                                                                    Phone # (Day):
 Address:                                                                                                 Phone # (Night):
                                                                                                          Relationship:

I understand that if I am employed, any misrepresentations or material omission made by me on this application will be sufficient cause for cancellation of
this application or immediate discharge from the employer's service whenever it is discovered.

I give the employer the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy
of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering and using such
information and all other persons, corporations or organizations for furnishing such information.

The employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any
applicant from consideration for employment on a basis prohibited by local, state or federal law.

This application is current for only 90 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for
employment, it will be necessary to fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to
terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not
constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of the employer,
other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in
writing and signed by an authorized officer.

I understand it is this company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable
accommodation as required by the ADA. I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.

I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.

SIGNATURE OF APPLICANT ____________________________________________________________________ DATE _____/_____/_____

                                                                         Equal Opportunity Employer
                          ACKNOWLEDGEMENT DRUG-FREE WORKPLACE

Hilo Hattie, Pomare Collections and Hilo Hattie Collections (hereafter referred to as the Company) recognizes that
it is important to protect the health and safety of its employees, guests and the general public, and to improve the
physical fitness and ability of its employees to perform their job. To assist us in achieving this goal, the Company
has adopted a Drug-Free Workplace Program (for controlled substances and alcohol). The goals of this program
are to educate employees about the problems of substance abuse and addiction, to assist employees in overcoming
such problems, and to provide fair treatment of employees who are substance abusers.


                              POST-OFFER TEST FOR JOB APPLICANTS

All individuals who have received an offer of employment to work with the Company must successfully pass a drug
and alcohol test before beginning actual employment with the Company.


I hereby acknowledge that a Drug Testing Program exists at Hilo Hattie, Pomare Collections and Hilo Hattie
Collections and I agree to abide by it.


__________________________________________                            ________________
Signature                                                             Date

___________________________________________
Print Name

                           HAWAII DRUG TESTING DISCLOSURE FORM
TO THE APPLICANT/EMPLOYEE:

The purpose of this form is to provide you information about the drug testing that you are being requested to
undergo by the Company. Unless otherwise notified by the Company, drug testing means urinalysis for the
presence of marijuana, cocaine, opiates, amphetamines (including crystal methamphetamine), and phencyclidine
(PCP).

You are advised that over the counter medications or prescribed drugs may result in a positive test result for drug
testing. For this reason, the Company’s Medical Review Officer may need your assistance in identifying which
medications or drugs you may be taking at the present time or may have taken within the past thirty (30) days to
ensure accuracy of testing results.

(Appl drugfree 6/00)
                                               CONSENT AND DISCLOSURE FORM
DATE__________________________________                                                           LOCATION__________________________________

I understand that Pomare, Ltd. dba Hilo Hattie will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New York, NY
10011, as part of the procedure for processing my application for employment. I also understand that if my application for employment is granted, Pomare,
Ltd. dba Hilo Hattie may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew or
extend my employment, to the extent permitted by law.
I understand a consumer reporting agency's investigation may include obtaining information regarding bankruptcies covering up to the last ten (10)
years, obtaining information regarding civil suits, civil judgments, arrest records, and paid tax liens covering up to the last seven (7) years, obtaining
information regarding any other adverse item of information covering up to the last seven (7) years and obtaining information regarding references and
educational and employment verifications without any time limitations, subject to any limitations or exceptions applicable under state and federal law.
The investigation also may include obtaining information relating to criminal convictions without any time limitations, subject to state law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my acquaintances or
associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, personal characteristics or
standard of living. I understand such information may also be obtained through direct or indirect contact with former employers, schools, financial institutions,
landlords and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five days after the
Company receives my request or five days after the investigative consumer report was requested, whichever is later.
   By checking the box, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an investigative consumer
report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act
I also understand that before I am denied employment based, in whole or part, on information obtained in the consumer report and/or investigative consumer
report, I will be provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the
accuracy of any information in the report, I must notify Pomare, Ltd. dba Hilo Hattie within five business days of my receipt of the report that I am
challenging the accuracy of the information contained in this report with STERLING TESTING SYSTEMS, INC. and advise Pomare, Ltd. dba Hilo Hattie
as to the basis of my challenge.
In exchange for Pomare, Ltd. dba Hilo Hattie’s consideration of my employment application, I agree not to file or pursue any complaints, claims or legal
actions of any kind against STERLING TESTING SYSTEMS, INC. for providing the aforementioned information. I also agree not to file or pursue any
complaints, claims or legal actions against Pomare, Ltd. dba Hilo Hattie or any of its employees, representatives, or agents arising out of or in any way
related to conducting a background investigation.
I am consenting that a photocopy of this authorization be accepted with the same authority as the original, and I specifically waive any written notice
from any entity, which may provide information based on this authorized request.
I hereby consent to this investigation and authorize Pomare, Ltd. dba Hilo Hattie to procure a consumer report and/or investigative consumer report on my
background as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth, social security and the other information below for my own benefit and fully understand that all employment decisions
are based on legitimate non-discriminatory reasons.



First Name                                                                                                          Date of Birth (MM/DD/YYYY)


Last Name                                                                                                           Middle Name/Initial


Other Names Known By                                                                                                           Male       Female


Current Address                                                                                                                      #yrs at this address


City                                                                                        State             Zip Code


Previous Address                                                                                                                     #yrs at this address


City                                                                                        State             Zip Code


Driver’s License No.                                                                        State             Social Security No.

______________________________________________________________________                                                           ________________
Signature                                                                                                                        Date