Apply

Do you have a valid driver's license?

Yes No

Are you under age 18 ?

Yes No

if "YES", can you provide proof of your eligibility to work?

Yes No

Are you currently authorized to work in the United States?

Yes No

Proof of eligibility will be required if hired.

Position applied for (1) and wage desired (2) (Be specific)

Days/hours available to work

How many hours can you work weekly?

Weekend availability mandatory

Employment desired

FULL-TIME ONLY ART-TIME ONLY DELI/CASHIER (CIRCLE ONE OR BOTH)

When are you available to start work?

Do you have a dependable means of transportation?

Yes No

Do you have any physical limitations that would prevent you from lifting, sweeping, mopping, emptying trash, etc.? YES or NO If yes, please explain

Will you submit to a drug test?

Yes No

Have you ever been convicted of a crime?

Yes No

If yes, please explain

Answering yes to these questions does not constitute automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered

Work Experience
Please list your work experience beginning with your most recent job held If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer, address, city, state and .zip code :

Name of last supervisor

Reason for leaving (be specific)

May we contact your present employer?

Yes No

Did you complete this application yourself

Yes No

I certify that the facts contained in.this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained.herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specitied period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This wavier does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilitles Act (ADA) and other relevant federal and state laws.

Apply

Grands Application Form