Application Old Town Family Market

Employment Application - OLD TOWN FAMILY MARKET
Fill the form below accurately indicating your potentials and suitability to job applying for.
The Civil Rights Act of 1964, as amended, prohibits discrimination in employment because of race, color, sex, religion, or national origin. The Age Discrimination in Employment Act of 1967, as amended, prohibits discrimination because of age. Various state laws prohibit some of the above as well as other types of discrimination. As an equal Opportunity Employer, Cub Foods intends to comply fully with all applicable employment laws.
Name
First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Earnings expected (per hour)
If you are under 18 years of age, please provide date of birth:
Referred to CUB FOODS from what source?
Are you employed now?
This application is for: (choose one or both)
If temporary, please note dates:
Please provide the names, relationship, and store location of any relatives working at CUB FOODS:
List your current availability: What DAYS & HOURS are you AVAILABLE?
EDUCATION & EMPLOYMENT HISTORY
EDUCATION: Specify highest grade completed, and type of school (high school, college, graduate, trade, etc.)
EMPLOYMENT HISTORY: Present or Most Recent Employer
REFERENCES
Please provide two references not related to you who have known you for at least one year.
Reference 1
Reference 2
Current or Most Recent Employer
I authorize CUB FOODS to contact and/or verify my employment, references, or any other background information. Further, I hereby release from all liability or damages those individuals, corporations, or organizations who provide such information. It is the policy of CUB FOODS to check and verify information on the application.
Name of Company
Type of Business
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
EMPLOYMENT DATES
From Date To Date
Supervisor's name
First NameLast Name
Supervisor's title
Supervisor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Your position title
Skills needed or acquired while in this position
Reason for leaving?
May we contact this employer?
Final salary (please specify per hour, per week, etc.)
It is understood that if my application is considered favorably, any false or misleading statement or information submitted on this application may result in immediate dismissal without notice.
Upon entering the employ of CUB FOODS, I agree to be governed and abide by all rules and regulations of my employer and to perform satisfactorily such duties as may be assigned tome from time to time. I understand that my employment is for no definite or fixed period of time, and that neither hours or work which may be assigned to me at any time, nor any other act or circumstances, shall constitute a guarantee of employment, or as to daily or weekly straight time or overtime working hours; if any. I further understand that if employment is offered to me by CUB FOODS, it will be on an at will basis, and may be terminated at any time, by either party, with or without cause. No representative of CUB FOODS has the authority to make contrary agreement.
I hereby certify the statements and information made in this application are, to the best of my knowledge, completely true and correct, and that I have read the above notice.
Signature
Date
MonthDayYear
Date
Should be Empty:

Employment Application - OLD TOWN FAMILY MARKET

EDUCATION & EMPLOYMENT HISTORY

REFERENCES

Current or Most Recent Employer

EMPLOYMENT DATES