Employment Application – Adults

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Employment Application

FOR ADULTS (18 years or older)

"We are an equal opportunity employer."

This application will be kept on file for 6 months from date of application (for store to fill):

Mgr _________________________________________

Date ________________________

(NOTE: If you feel that your civil rights would be violated by answering a question on this form, please omit the answer to that question with a hypen (-).)

Date

First Name

Last Name

Street Address

City

State

ZIP Code

Home/Cell Phone Number

Other Phone Number

Position Desired

Choose One:

Full-timePart-timeTemporary

Store LocationIf applying for management, select "Store Management."

For those applying to Management ONLYWhich store are you applying to?

Are you 18 or older?

Yes No

U.S. ARMED FORCES HISTORY

U.S. Armed Forces Service

YesNo

Branch of Service

From - To

GENERAL INFORMATION

GENERAL: List outside interests(Clubs, Organizations, Sports, Hobbies) Need not list any interests which would indicate your religious or ethnic background.

Have you ever been convicted of a crime?

YesNo

If yes, please give full details.

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INCASE OF ACCIDENT OR EMERGENCY PLEASE NOTIFY:Name, Relationship, Address, Phone Number

EDUCATION

HIGH SCHOOLSchool Name

Years Completed(i.e. 9-12)

Diploma

YesNo

Describe course of study.

Describe special training, apprenticeship, skills, and extracurricular activities.List as many or as few as you would like.

COLLEGE / UNIVERSITYSchool Name

Years Completed(i.e. 1-4)

Degree

YesNo

Describe course of study.

Describe special training, apprenticeship, skills, and extracurricular activities.List as many or as few as you would like.

GRADUATE / PROFESSIONALSchool Name

Years Completed(i.e. 1-3)

Degree

YesNo

Describe course of study.

Describe special training, apprenticeship, skills, and extracurricular activities.List as many or as few as you would like.

Have you been employed by us before?

YesNo

If yes, please give dates employed.

Have you ever been discharged from any position?

YesNo

If yes, please explain.

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Do any of your friends or relatives work here?

YesNo

If yes, please list their names.

EMPLOYMENT EXPERIENCE / WORK HISTORY

Omit Military Service History – Give Present or Most Recent Position First

Information must be complete and accurate.

Start with your present or last employer. If you need more space, use an extra sheet of paper. If summer or part-time work, please indicate. If you were employed under a maiden or other name, please indicate that name by the employer.

EMPLOYMENT: May we request references from your present or past employers?

YesNo

EMPLOYMENT EXPERIENCE #1Employer Name

Phone No.

Address

Type of Business

Date Hired

Date Left

SupervisorName/Title

Your Title & Duties

Starting Pay

Pay at Leaving

Reason for leaving

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EMPLOYMENT EXPERIENCE #2Employer Name

Phone No.

Address

Type of Business

Date Hired

Date Left

SupervisorName/Title

Your Title & Duties

Starting Pay

Pay at Leaving

Reason for leaving

0 /

EMPLOYMENT EXPERIENCE #3Employer Name

Phone No.

Address

Type of Business

Date Hired

Date Left

SupervisorName/Title

Your Title & Duties

Starting Pay

Pay at Leaving

Reason for leaving

0 /

Is this a complete list of employment?

YesNo

Are we granted permission to check all information?

YesNo

If any, indicate by # any of the employers whom you do not want us to contact.(i.e. Employer Experience #1)

We are an equal employment opportunity company. We are dedicated to a policy of non-discrimination in employment on any basis, including race, creed, age, sex, religion, national origin, height, weight, marital status, or disability.

I certify that the information contained in this application is correct to the best of my knowledge and understand that deliberate falsification of this information is grounds for dismissal in accordance with this company’s policy. I authorize the references listed above to give you lawful information concerning my previous employment. I agree to undergo a character investigation and I agree to take an honest verification test in accordance with State and Federal laws upon reasonable suspicion of any and all discrepancies involving my work. I understand that no representative of the company except the President has the authority to enter into my agreement for employment for any specified period of time, nor am I obligated to work for the company for any specified period of time. The President’s agreement must be in writing.

I understand that my electronic signature below serves as my signature.

Yes

SignFull Name

Email AddressIf you would like a copy of your application, list your email.

reCaptcha v3

IF HIRED, COMPLETE THE FOLLOWING

I HAVE RECEIVED A COPY OF HOLLYWOOD MARKETS RULES AND POLICIES.

SIGNED: _________________________________________

DATE:

I UNDERSTAND THAT MY REGISTER SHORTAGES WHICH EXCEED 50¢ WILL BE DEDUCTED FROM MY PAY.

Uncollected checks accepted without following Hollywood’s rules & policies will be deducted from my pay.

SIGNED: _________________________________________

DATE:

NOTE: This application will be kept current for six months. You need to complete another to be reconsidered after this date.

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Employment Application – Adults

FOR ADULTS (18 years or older)

About Hollywood Markets