Employment

Employment Application

In order for you to be considered for employment, this application must be filled out in its entirety. Provide all information requested. Complete all sections or mark N/A for sections not applicable to you. Your complete application form will be maintained in our active files for three (3) months from the date of application. You may submit a new application at any time.

An Equal Opportunity Employer

We are an equal opportunity employer, and we do not and will not discriminate on the basis of race, religion, national origin, sex, age, handicap, marital status, or veteran status. Information provided on this application will not be used for any discriminatory purpose.

* All Fields On This Application Form Are Required

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Today's Date

Last Name:

First Name:

Middle Name:

Mailing Address:

Email:

Phone:

Are you at least 18 years of age?

Yes

If No, what is your age?

Are you a U.S. Citizen?

Yes

If No, are you legally eligible to work in the U.S.?

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(Proof of citizenship or eligibility is required upon employment.)

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Employment Desired

Select the position you are applying for:

Date you can start:

Salary Desired:

Do you desire?

Full-Time Work

Part-Time Work

Either

Will you work nights?

Yes

Will you work Weekends?

Yes

Are you employed now?

Yes

If so, may we contact your present employer?

Yes

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Availability

Check here if available any time during the week, otherwise indicate times available in the table below.

Available To Work Anytime

Days you are available to work are?

I am available to work:

All Year

School Year

Summer

Number or hours needed to work per week:

Minimum Hours:

Maximum Hours:

Do you have reliable transportation, including public transportation, to get to work?

Yes

If given a job, how long do you expect to work here?

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Miscellaneous

Do you have any relative(s) currently employed by Tallassee Super Foods?

Yes

Have you ever been convicted of any crimes other than minor traffic violations?

Yes

A conviction record will not necessarily bar you from employment. If Yes, please list:

What do you think are the most important factors in working at a grocery store?

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Employment Record

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Most Recent Employer

Company:

Address:

Phone Number:

Brief Description of Duties:

Dates Worked (From-To):

Reason For Leaving:

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Previous Employer

Company:

Address:

Phone Number:

Brief Description of Duties:

Dates Worked (From-To):

Reason For Leaving:

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Previous Employer

Company:

Address:

Phone Number

Brief Description of Duties:

Dates Worked (From-To):

Reason For Leaving:

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Education

High School Name:

City/State:

Years Attended:

Did you graduate?

Yes

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Other Schooling

School Name:

City/State:

Years Attended

Did you graduate?

Yes

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References

Please enter their Name, Title/Relationship, Phone Number and the Years you have known them.

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References

Please enter their Name, Title/Relationship, Phone Number and the Years you have known them.

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References

Please enter their Name, Title/Relationship, Phone Number and the Years you have known them.

Professional memberships, certificates, or licenses held:

What are your hobbies, activities, interests, and involvements? Also list awards, and/or leadership positions held:

Please list any special skills and abilities you have that may be useful in the position you are applying for.

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I hereby certify that the answers and other information on this application are true and complete to the best of my knowledge and that I understand any misrepresentation or omission of facts on my part will be justifiable grounds for dismissal, if employed. I authorize investigation of all statements contained herein and the references listed above to give you any and all information regarding my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing the same to you. I understand and agree that, if hired, my employment is for no definite period and may regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause.

Furthermore, I understand that the use of drugs or alcohol at work or on company property is strictly prohibited. Tallassee Super Foods reserves the right to randomly test the employees for the use of drugs. Prior to employment or acceptance of employment with Tallassee Super Foods, you agree to comply with the above policy.

Electronic Signature:

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Employment Application

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