APPLICATION FOR EMPLOYMENT - Gerrity's Supermarkets
APPLICATION FOR EMPLOYMENT
PERSONAL INFORMATION
Date _________
Name ____________________________________
Social Security ___________
Address __________________________________
Phone _________________
are you 18 years old? ________
Are you prevented from lawfully becoming Employed in this country because of Visa or Immigration status? _____________
EMPLOYMENT DESIRED
Position _________________
Start Date __________
Salary ___________
Are you employed now? ______ May we inquire of your present employer? _______
Ever applied to this company before? ______
Where? ______
When? _____
Referred By __________________________________
EDUCATION
Grammar School _______________________ No. of Years Attended? _________
Address __________________________
Subjects Studied _______________
City/State/Zip ______________________________
did you graduate? ________
High School _______________________ No. of Years Attended? _________
Address __________________________
Subjects Studied _______________
City/State/Zip ______________________________
did you graduate? ________
EDUCATION cont.
College __________________________
No. of Years Attended? _________
Address __________________________
Subjects Studied _______________
City/State/Zip ______________________________
did you graduate? ________
Trade School _______________________
No. of Years Attended? _________
Address __________________________
Subjects Studied _______________
City/State/Zip ______________________________
did you graduate? ________
GENERAL Subjects of special study or research work ____________________________________ ______________________________________________________________________
Special Skills ___________________________________________________________ Activities: (civic, athletic, etc.) _____________________________________________
U.S. Military or Naval Service _________________________ Rank ____________ Present Membership in National Guard or Reserves ____________________________
FORMER EMPLOYERS (Start with last one first)
Employer Name _________________________ Dates of employment ___________
Address ________________________________
Position ________________
City/State/Zip _____________________________________
Salary ____________
Reason for leaving _______________________________________________________
FORMER EMPLOYERS cont.
Employer Name _________________________ Dates of employment ___________
Address ________________________________
Position ________________
City/State/Zip _____________________________________
Salary ____________
Reason for leaving _______________________________________________________
Employer Name _________________________ Dates of employment ___________
Address ________________________________
Position ________________
City/State/Zip _____________________________________
Salary ____________
Reason for leaving _______________________________________________________
Employer Name _________________________ Dates of employment ___________
Address ________________________________
Position ________________
City/State/Zip _____________________________________
Salary ____________
Reason for leaving _______________________________________________________
REFERENCES (Three persons not related to you, whom you have known for at least one year)
Name __________________________
Business ___________________
Address _____________________________
Years acquainted _____________
City/State/Zip __________________________________________
Name __________________________
Business ___________________
Address _____________________________
Years acquainted _____________
City/State/Zip __________________________________________
REFERENCES cont.
Name __________________________
Business ___________________
Address _____________________________
Years acquainted _____________
City/State/Zip __________________________________________
" I certify that all the information submitted by me on this application us true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."
Date __________ Signature ____________________________________________
................
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