Employment Application

    * denotes a required field.

    Today's Date*


    What position(s) are you applying for?*
    BakeryProduceDeliCashierBaggerMeatStock


    Personal Information

    Applicant's Name*
    First Name:
    Last Name:
    Applicant's Address*
    Address Line 1:
    Address Line 2:
    City:
    State:
    Zipcode:
    Applicant's Phone Number*
    Phone:


    Are you at least 16 years old?*
    YesNo

    Are you at least 18 years old?*
    YesNo


    List outside activities*


    Work Availability

    Type of employment desired*
    Full TimePart Time


    Number of hours available to work each week*


    Do you have any commitments to another employer that might affect your employment with us?*
    YesNo


    Are you legally eligible for employment in this country?*
    YesNo


    General Information

    Have you ever worked for this company before?
    YesNo


    Does this company employ any of your relatives?*
    Yes (List names and relationship in box below)No


    Have you ever been convicted of a crime, excluding misdemeanors and traffic violations? *
    Yes (Describe in full in box below)No (Move on to next question)



    Educational History

    What is the last grade in high school that you completed?*
    8 or less9101112GED


    Name and location of high school*


    What was the last year of college, tech, or business school that you completed (if any)?*
    None1234


    If you attend / attended college, tech, or business school, What is your major course of study?


    What school activities / organizations including athletics, did or do you participate in?*


    Work History

    Information must be complete and accurate. Give present or most recent position first (if any).

    Company Name:
    Company Location:
    Company Phone Number:
    Employment Dates:
    Position Held and Rate of Pay:
    Supervisor's Name and Title:
    Can we contact this employer?: YesNo


    Major Responsibilities:


    Reasons for Leaving:


    Next most recent employer (if any)

    Company Name:
    Company Location:
    Company Phone Number:
    Employment Dates:
    Position Held and Rate of Pay:
    Supervisor's Name and Title:


    Major Responsibilities:


    Reasons for Leaving:


    Required

    Evening and weekend hours are required.

    We do not hire for specific shifts or hours.

    Applicant must be available for different shifts each week.