Dios

Today’s Date: Referred by:

Application for Employment www.tjx.com

Please print clearly in ink. The TJX Companies, Inc. considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual’s status in any group or class protected byapplicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require an accommodation in the application process, please advise Management.

PERSONAL DATA
FULL NAME:
Last First Middle

CURRENT ADDRESS:
Street and Number

CityState

Zip Code

PREVIOUS ADDRESS:
Street and Number

City

State

Zip Code

Preferred Name/Nickname
(Optional)

Home Telephone Number

Cell Phone Number
(Optional)

E-Mail Address
(Optional)

Have you ever applied to HomeGoods, Marshalls, T.J. Maxx or The TJX Companies, Inc.? q Yes q No If yes, provide dates: Have you ever worked for HomeGoods, Marshalls, T.J. Maxx orThe TJX Companies, Inc.? q Yes q No If yes, provide dates: Location: Do you know anyone who works for any of the TJX divisions? q Yes q No Name: How were you introduced to us? q Other q Employee Referral q College/University q Newspaper ad q Dept. of Employment q Yes q No q Walk in q Internet q Community Organization

If hired, and you are under 18, can you furnish a work permit?

q 18 or overq Yes q No

If hired, can you provide proof of identify and authorization to work in the United States?

EMPLOYMENT DESIRED
Position you are applying for: Date Available for work*: Total hours available per week*: What type of work are you looking for? Are you willing to relocate? q Yes q No q Part-time If yes, where? From To q Full-time q Regular q Temporary Will you travel? S M T W T F S*Should your availability change during the course of your employment, it may impact your employment status based on business needs. While we may be able to accommodate your availability limitations upon hire, we do not guarantee that we will be able to support these limitations in the future. Should our business needs change, we may require an adjustment in your availability in order to maintainemployment status. TJXAPP Rev 1/11

EXPERIENCE
Please give accurate and complete information. Start with present or most recent employer, including self-employment, part-time work, military employment and any work performed on a volunteer basis. Account for your entire employment history, including significant gaps in employment. All information must be included, even if you are attaching aresume.
Employer Address (Street, City, State) Work Performed

Telephone Number(s) ( ) Job Title Reason for Leaving Supervisor

Dates Employed From: Employer Address (Street, City, State) To:

Hourly Rate/Salary Starting: Final: Work Performed

Telephone Number(s) ( ) Job Title Reason for Leaving Supervisor

Dates Employed From: Employer Address (Street, City, State) To:

HourlyRate/Salary Starting: Final: Work Performed

Telephone Number(s) ( ) Job Title Reason for Leaving Supervisor

Dates Employed From: Employer Address (Street, City, State) To:

Hourly Rate/Salary Starting: Final: Work Performed

Telephone Number(s) ( ) Job Title Reason for Leaving Supervisor

Dates Employed From: To:

Hourly Rate/Salary Starting: Final:

Please attach an additional sheet ifnecessary.

EDUCATION
Circle highest grade completed: HIGH SCHOOL
Name of School City State

Elementary 6 7 8

High School 9 10 11 12

College 13 14 15 16 17 18 19

DIPLOMA OR GED RECEIVED:

q Yes q No

COLLEGE: (List all, whether or not degree was obtained)
NAME LOCATION MAJOR FIELD OF STUDY MINOR FIELD OF STUDY DEGREES/ CERTIFICATION RECEIVED?

May we contact schools you...