Job Center
To apply for a position in our callcenter or warehouse, please fill out this questionnaire.
First Name
Middle Name
Last Name
Email Address
Phone #
Best Time To Call
Are you 18 or older?
yes
no
Street Address
City
State
Zip
Have you been known by another name?
yes
no
If yes, what?
Your interest in Heartland America
Call Center
Warehouse
Data Entry
Other:
Full Time (36 hours or more per week)
Part Time (29 hours per week or less)
Part Time Plus (30-35 hours per week)
Seasonal
Range of hours you're available to work:
Days you're available to work:
Have you applied at Heartland America before?
yes
no
If yes, when?
Have you worked at Heartland America before?
yes
no
If yes, why did you leave?
How did you hear about us?
Please select one
Heartland America Website
Newspaper:
Online:
Heartland America Employee:
Other:
Employment History
Please give an accurate, full time and part time employment record. Start with your present or most recent employer.
1
Employer
Telephone
Address
Supervisor's Name and Title
Employed
from
To
Describe the Work you did
Hourly Rate
Begin
End
May we contact this employer?
yes
no
Explain your reasons for leaving
2
Employer
Telephone
Address
Supervisor's Name and Title
Employed
from
To
Describe the Work you did
Hourly Rate
Begin
End
May we contact this employer?
yes
no
Explain your reasons for leaving
3
Employer
Telephone
Address
Supervisor's Name and Title
Employed
from
To
Describe the Work you did
Hourly Rate
Begin
End
May we contact this employer?
yes
no
Explain your reasons for leaving
Education
List the highest level of education achieved
Name and Address of School
Years Completed
1
2
3
4
Did you graduate?
yes
no
Course of Study
Degree Earned
Have you completed any other courses or training programs that would impact your work at Heartland America?
Do you have experience in any of the following areas? Check all that apply.
Sales
Telemarketing - Inbound or Outbound
Retail
Upselling products or services
None of the Above
Do you have customer service or related experience?
yes
no
Are you familiar with a keyboard, and do you have basic computer skills?
yes
no
References
1
2
3
If offered a position, when would you be able to start?
Immediately
Within 2 weeks
Within one month
More than one month
