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O&O HR 8/2016

New Hire Checklist

Employee First Name: ____________________ Employee Last Name: ___________________________

Date of Hire: ___________________________ Location: ______________________________________

Position (Circle): Sales Associate / Sales Lead / Assistant Manager / Store Manger

Status (Circle): Full-time / Part-time / Seasonal Store Manager: __________________________

SSN: ______________________ Date of Birth: __________________ Sex (Circle): Male/Female

Cell #: ____________________ Employee Personal Email: ________________________________

Mandatory documents to be returned to HR Date Completed

PAF (Full-Time Only)

Retail New Hire Start Form (Part-Time Only)

I-9 documents(2 pages)

Copy of the identification used for the (I-9)

Federal Tax form W-4(s)

State Tax form (if State requires)

Affirmative Action Questionnaire

Employee Purchase Program and Procedure Signature Page

Internal Rules Acknowledgment Signature Page

Employee Personal Info Form (including voided check)

Receipt of Handbook Signature Page

Completed Employment Application

Resume (if available)

Signed Offer letter (Full-Time Only)

Interview Evaluation Form

Schedule Availability Form

Manager Signature___________________________________________________________________

Manager Name (Printed) ________________________________ Date completed________________

***Please submit all New Hire Paperwork in the HR portal (Zendesk) under the original ticket the

cleared Drug/Background request results were posted.

O&O HR 8/2016

Retail New Hire Start Form

(Part Time Employees Only)

First Name: _________________________________ Last Name: _______________________________

Cell #: _________________________________ Email: ________________________________________

Pay Rate: ____________________________________________________________________________

Position: Sales Associate / Seasonal Sales Associate

Location: ____________________________________________________________________________

Store Manager: _______________________________________________________________________

Start Date: ___________________________________________________________________________

Bonus Plan:

Current Pay Rate:

DATE:

DATE:

DATE:

PERSONNEL ACTION FORM (PAF)

PVLLCVentures

US

Payment Frequency:

Global-Region-US:Employee Name:

Payroll Company:

Current Job Title:

Supervisor/Manager:

Position Level:

Department/Store:

Type of Change:

Effective Date:

People Manager:

Change Reason:

Direct Reports (please list):

REASONS TO COMPLETE A PERSONNEL ACTION FORM

JOB/STATUS CHANGE

New Job Title: New Payroll Company:

Monthly Car Allowance:

Status:

Annual Bonus: Target Amount: Target Percent:

NEW HIRE INFO

Pay Rate: Pay Type:

New Supervisor/Manager:

PAY CHANGES

Current Pay Type:

New Department/Store: Status Change to:

Internal Fill:

Bonus Plan: Payment Frequency:

OTHER CHANGES/NOTES

New Pay Rate: New Pay Type:

Annual Bonus: Target Percent: Target Amount:

If Termination, and People Manager: New Supevisor/Manager for Direct Reports:

NACHRO SIGNATURE:

(if applicable)

(if applicable)

NA

MANAGER SIGNATURE:

ET LEADER SIGNATURE:

APPROVALS

Eligible for Rehire: Vacation Hours Owed:

SEPARATION OF EMPLOYMENT **(Please attach all supporting documentation)**

Last Day Worked:

Monthly Car Allowance:

O&O HR 8/2016

I9 Identification

ACThomas

Typewritten Text

ACThomas

Typewritten Text

ACThomas

Typewritten Text

O&O HR 2/2016

Employee Personal Information

General

First Name: ____________________ Last Name: _______________________ Date: ________________

Address: _____________________________________________________________________________

City: _________________________________ State: ____________________ Zip code: _____________

SSN: ______________________ Date of Birth: __________________ Sex: Male Female

Cell #: _________________________________ Email: ________________________________________

Emergency Contacts

In Case of Emergency, please contact:

Emerg. Contact Name: _______________________________ Relationship: _____________________

Emerg. Contact Address: _______________________________________________________________

Emerg. Contact Phone #: _______________________ Emerg. Contact Alt. Phone #: _______________

2nd Emergency Contact (In case 1st contact cannot be reached):

Emerg. Contact 2 Name: ______________________________ Relationship 2: ___________________

Emerg. Contact 2 Address: _____________________________________________________________

Emerg. Contact 2 Phone #: ___________________ Emerg. Contact 2 Alt. Phone #: ________________

Direct Deposit

***VOIDED CHECK OR BANK AUTHORIZATION MUST BE PRESENT***

Bank Name: ______________________________________ Account Type: Checking Savings

Routing Number: ________________________ Account Number: _____________________________

To Add 2nd Account (not required)

Bank Name: ______________________________________ Account Type: Checking Savings

Routing Number: ________________________ Account Number: _____________________________

Amount of Deposit: $__________________________________________________________________

_________________________________ _____________________________

Employee Signature Date

O&O HR 8/2016

Voided Check or Bank Authorization Form

PANDORA Jewelry LLC 8681 Robert Fulton Dr.

Suite C Columbia, MD 21046 pandora-jewelry.com

I hereby acknowledge I have received and read the following documents from the PANDORA

Jewelry:

1. Handling and Disclosure of Inside Information of Management and Employees

2. Trade in the Pandora A/S Securities by Management and Employees

3. Internal Rules – Introduction to common terms

_________________________________

Employee Name (Please Print)

_________________________________ _____________________________


O&O HR 10/2015

Employee Jewelry Purchase Program and Procedure Acknowledgement

I, the employee, hereby acknowledge that I have received and read a copy of the PANDORA Employee

Jewelry Purchase Program. I agree to conform to the rules, policies, procedures, and directives

described in the Employee Jewelry Purchase Program and Procedure.

I further understand and agree that:

1. Additional information and policies may be implemented at any time by PANDORA, and I will also be required to read and understand them.

2. Abuse of the discount benefit or violation of the guidelines or restrictions included in the Employee Jewelry Purchase Program and Procedure may result in disciplinary action up to and including separation of employment.

Signature of Employee:

Printed Name of Employee:

Date:

10/2015

Print Name (First, Last):_____________________________________________ Date: ___________________ Please check the box next to the appropriate answer.

1. Gender ☐ Male ☐ Female

2. Racial Group

☐ White

☐ Black or African American

☐ Hispanic or Latino

☐ Native Hawaiian or Other Pacific Islander

☐ Asian

☐ American Indian or Alaskan Native

☐ Two or More Races

☐ I decline to Answer

3. Veteran Status A “disabled veteran” is one of the following:

A veteran of the U.S. military who is entitled to compensation under laws administered by the Secretary of Veterans Affairs; or

A person who was discharged or released from active duty because of a service connected disability

A “recently separated veteran” means a veteran who was discharged or released from active duty in the US military within the past three years An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the US military during a war, or in a campaign or expedition for which a campaign badge was authorized An “armed forces service medal veteran” means a veteran who participated in a United States military operation for which an armed forces service medal was awarded

☐ I identify as one or more of the classifications of protected veterans listed above

☐ I am not a protected veteran

☐ I decline to answer

4. Disability You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Examples of disabilities include, but are not limited to: blindness, deafness, cancer, diabetes, epilepsy, autism, cerebral palsy, HIV/AIDS, schizophrenia, major depression, multiple sclerosis, missing limbs, and others.

☐ Yes, I have a disability

☐ No, I don’t have a disability

☐ I decline to answer

AVAILABILITY ACKNOWLEDGEMENT

Employee First Name: __________________________ Last Name: ______________________________

Store Name: __________________________________Date of Hire: _____________________________

Day of the Week Range of Hours Available

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

I will be expected to meet my commitment to this availability. If I have availability changes, I will submit

my new availability request to my Store Manager in writing. I understand that Pandora is not obligated

to agree to a new availability request.

I understand the Store Manager will make an effort to support occasional changes in availability. I also

understand that in order for my availability change request to approved, it must meet the needs of the

business and if it is not approved, it may result in a reduction of my scheduled hours. I further

understand that the scheduled hours I receive will be based on business needs, my availability and my

performance. I am not guaranteed any specific hours per week, and my days off and shifts may vary

from week to week. In addition, I understand that if I am unable to work the hours that I have indicated

as available in the chart above, my employment may be terminated.

Finally I understand and acknowledge that nothing contained in this document alters my status as an at-

will employee which means that either I, or Pandora, may terminate the employment relationship with

or without notice and with or without cause.

_________________________________ _____________________________


_________________________________ _____________________________

Store Manager Signature Date

O&O CANDIDATE INTERVIEW EVALUATION FORM – Sales Associate

Candidate Name: Store Name:

Interview Completed by: Date of Interview:

COMPETENCY

CANDIDATE RATING

Communication: Candidate expresses thoughts clearly and projects a positive manner in all forms of communication. Strong listening skills are shown and ability to work with customers and clients.

Below Expectations

Meets Expectations

Exceeds Expectations

Exceptional

Work Experience: Candidate possess experience directly related to the position and acquired the necessary skills or qualifications through past work experiences. Ability and desire to learn the skills to be successful.

Below Expectations

Meets Expectations


Exceptional

Sales Ability & Customer Service: Candidate demonstrates strong sales orientation with the ability to provide clear and consistent information and service. Able to create a positive customer experience.

Below Expectations

Meets Expectations


Exceptional

Pride, Passion & Performance: Candidate showed interest in the position and company. Ability to articulate goals relevant to the position and aligned with the company values.

Below Expectations

Meets Expectations


Exceptional

Overall Impression and Comments: Overall Rating: Below Expectations Meets Expectations Exceeds Expectations Exceptional Next Steps: Yes No

OF 4PANDORA Jewelry, LLC • 250 W. Pratt Street, Baltimore MD, 21201• 410-309-0200 • PANDORA.NETRev. 033116

It is important that you answer all the items on this application. Take time to list pertinent information carefully and completely. Your ability to write clearly and effectively on this application will be considered if effective written communication is a requirement for the position for which you are applying. It is your responsibility to inform us of all education and experience related to the position for which you are applying. All information you provide on this form is subject to verification. PANDORA Jewelry, LLC makes all employment decisions in accordance with applicable federal, state, and local laws. These statutes prohibit discrimination in employment based on an individual’s gender, race, color, religion, national origin, sexual orientation, marital status, age, disability, genetic information, status as a covered veteran and other protected status. If you need assistance in completing this application, please inform HR or hiring manager.

EMPLOYMENT APPLICATION

------- READ THE FOLLOWING INSTRUCTIONS CAREFULLY BEFORE COMPLETING YOUR APPLICATION -------

APPLICANT INFORMATION: (Please Print Clearly In Ink) _______________________ TODAY’S DATE: _________________

First Name: _________________________ Last Name ___________________________ Phone #1: ______________________

Address: _________________________________________________________________ Phone #2: ______________________

City: __________________________ State: _________ Zip code: _________________ Skype Name:____________________

Email: ___________________________________________________________________

Emergency Contact: __________________________ Phone#: ____________________ Relationship: ______________________

Are you under the age of 18? YES NO (If yes, a work permit will be required)

Have you been previously employed by PANDORA Jewelry, LLC? YES NO

If yes, please provide dates and position: ________________________________________________________________________

Have you been employed under another name? YES NO (If yes, please provide: _____________________________ )

How were you referred to us? __________________________________________________________________________________

Prefer: Full-time Part-Time Weekend Other _____________________________________________________

I’m willing to work: Day Evening Night Any Shift

Date available to start work: _____________________ Minimum salary expected: ______________________________________

Can you perform the essential functions to the positions for which you are applying with or without resonable accommodations?

YES NO

PLEASE LIST THE SPECIFIC POSITION(S) APPLIED FOR

(List in order of preference)

1. ___________________________________________________________________________________________________________________________________

2. ___________________________________________________________________________________________________________________________________

3. ___________________________________________________________________________________________________________________________________


A resume which gives a more detailed description of work performed or a listing of additional jobs may be included. If you submit a resume to supplement your work history, you must still answer the questions on this form relative to employment dates, salary and reasons for leaving. List below your past four (4) positions, beginning with the most recent and working back. Summarize all other positions on the last page or a separate sheet. It is your responsibility to provide accurate information to enable PANDORA to contact references.

WORK EXPERIENCE:

EMPLOYMENT DATES:_______________________ MM/DD/YY - MM/DD/YY

LAST SALARY: __________

Per Year Per Hour

BONUS/INCENTIVE PAY:_______________________

YOUR TITLE:_________________________

EMPLOYER INFORMATION:Name: ___________________________________Address: __________________________________________________________________________

SUPERVISOR INFORMATION:Name: ___________________________________Title: ____________________________________Phone #: _________________________________

Describe your work/Job Responsibilities:________________________________________________________________________________________________

Reason for leaving:________________________________________________________________________________________________



Per Year Per Hour


YOUR TITLE:_________________________







Per Year Per Hour


YOUR TITLE:_________________________







Per Year Per Hour


YOUR TITLE:_________________________






NAME & ADDRESS COURSE OF STUDY YEAR COMPLETED DEGREE / LICENSE COMPLETED

High School GED

Name:

Address:Check one:

1 2 3 4

Degree Awarded?

YES NO

Type: Diploma / GED

Date:

College Technical Professional School

Name:

Address:

Check one: 1 2 3 4

Degree Awarded?

YES NO

Type:

Date:

Other ________________

Name:

Address:Check one:

1 2 3 4

Degree Awarded?

YES NO

Type:

Date:

SCHOOL INFORMATION:

Are you legally eligible to work in the United States? YES NO

Pursuant to the Immigration Reform and Control Act of 1996, all applicants, upon being made an offer of employment, must produce documents which are specified by the federal governments, establishing their identity and eligibility to work in the United States. These documents must be produced no later than seventy two (72) hours after commencement of employment. You will also be required to sign form I-9 (issued by the federal government) verifying, under oath, your eligibility to work.

Please complete all information including current addresses and phone numbers with area code for all references. Failure to do so may prevent consideration of your application.

PLEASE LIST 2 PROFESSIONAL REFERENCES (Do not include relatives or personal contacts)

Name: _____________________________________________

Email Address: ______________________________________

Phone #: ___________________________________________

Work Relationship: __________________________________

Name: _____________________________________________

Email Address: ______________________________________

Phone #: ___________________________________________

Work Relationship: __________________________________

State names of relatives working for PANDORA Jewelry: __________________________________________________________

EDUCATION:

PROFESSIONAL LICENSES, REGISTRATIONS AND/OR CERTIFICATIONS

Type State Issued Date No.

1. ___________________________________________________________________________________________________________________________________

2. ___________________________________________________________________________________________________________________________________

3. ___________________________________________________________________________________________________________________________________


APPLICANT ACKNOWLEDGEMENT

Summarize all other experience here. Describe your skills and your ability to apply them to the job(s) for which you are applying:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

MASSACHUSETTS APPLICANTS NOTE: It is unlawful in Massachusetts to require or administer a lie detector as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

MARYLAND APPLICANTS ONLY: Under Maryland Law, an employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a polygraph examination or similar test. An employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100.

I certify that the answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers in any application document may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts in any application document may be cause for my dismissal at any time without prior notice. I consent to and authorize PANDORA Jewelry, LLC to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools and personal references to give PANDORA Jewelry, LLC (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against any party or parties for providing a good faith reference.

I expressly agree and understand that, if employed, my employment is at-will and is not for a specific term, is based on mutual consent and may be terminated by me or my employer with or without notice or cause at any time. I further understand that no oral promise, employer policy, custom, business practice or other procedure (including PANDORA’s employment policies, personnel handbook or any personnel manuals) constitutes an employment contract or modification of the at-will employment relationship between me and the employer. I also understand that this aspect of my employment may not change absent an individual written agreement signed by both me and the president of PANDORA Jewelry, LLC. I understand that applicants for certain positions may be required to qualify for employment based on additional employment criteria. For example, I may be required to take job-related tests; take a driver’s examination; submit to a background or credit investigation; and/or take a pre-employment drug test. If I am offered employment or start work before any required test is completed, my employment is contingent on a satisfactory result on all required tests. I authorize the release of any background check results or any drug test to any state or federal authority requesting such information or in response to a valid subpoena or other legal document.

In the event of my employment with PANDORA Jewelry, LLC, I will comply with all rules regulations, and policies set forth in the PANDORA Jewelry, LLC’s policy manual or other communications distributed by PANDORA Jewelry, LLC. PANDORA Jewelry, LLC is an at-will employer. I understand that nothing in this employment application, in the company’s policy statements or human resources guidelines, or in my communications with any PANDORA Jewelry, LLC officials is intended to create or constitute an employment contract between PANDORA Jewelry, LLC and me. This application for employment is good for 60 days only. Consideration for employment 60 days from the date of this application will require a new application.

!

SIGNATURE DATE

!

SIGNATURE DATE

WE ARE AN EQUAL OPPORTUNITY EMPLOYER.

MUST SIGN BOTH FIELDS BELOW BEFORE SUBMITTING APPLICATION

SUMMARY:

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