Application for Employment

Damm Pharmacies is an equal opportunity employer.

Personal Information

Current Address

Are you 18 years or older?
Are you prevented from lawfully becoming employed in this country because of visa or immigration status?

Employment Desired


Are you employed now?
If so may we contact your present employer?


Did you graduate high school or receive a GED?

Did you graduate?


Are you able to work Saturdays?

Have you had any moving traffic violations in the last two years?

Do you agree to a pre-employment drug screen?

Former Employers

Please provide information on your last three employers starting with the the most current.


Give the names of three persons not related to you, whom you have known for at least one year.

"I certify that all of the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."