Application for Employment

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.

NAME (First, MI, Last) *

ADDRESS (Street, City, State, Zip) *

PHONE *

EMAIL

POSITION APPLIED FOR: *Store Manager/TraineeCashierStock ClerkMeat CutterMeat ClerkProduce Manager/ClerkCustomer Service

HOURSFull TimePart TimeTemporary

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Employment Record (Please list the last 2 places of employment)

CURRENT OR MOST RECENT EMPLOYER

COMPANY NAME & ADDRESS (Street, City, State ZIP)

POSITION HELD

DATE STARTED

DATE ENDED

WEEKLY WAGE/HOURLY SALARY

REASON FOR LEAVING

PREVIOUS EMPLOYER

COMPANY NAME & ADDRESS (Street, City, State ZIP)

POSITION HELD

DATE STARTED

DATE ENDED

WEEKLY WAGE/HOURLY SALARY

REASON FOR LEAVING

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Education History (Most Recent)

HIGH SCHOOL NAME & ADDRESS (Street, City, State ZIP)

YEARS COMPLETED & DEGREE/DIPLOMA

COLLEGE NAME & ADDRESS (Street, City, State ZIP)

YEARS COMPLETED & DEGREE/DIPLOMA

TECH TRAINING NAME & ADDRESS (Street, City, State ZIP)

YEARS COMPLETED & DEGREE/DIPLOMA

OTHER EDUCATION NAME & ADDRESS (Street, City, State ZIP)

YEARS COMPLETED & DEGREE/DIPLOMA

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SKILL RECORD (check all that apply by pressing the CTRL button and selecting with the mouse).Bagging ProduceBookkeepingHandling CashMaintenance & Janitorial WorkMeat cuttingMeat preparationPackaging MeatProduce preparationRunning a Cash RegisterMaking out Grocery OrdersStocking Shelves

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IF YOUR APPLICATION RECEIVES FAVORABLE CONSIDERATION, WHEN WILL YOU BE ABLE TO START WORK?

CAN START ON: *

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