Application for Employment
* indicates a required Field
* First name:
* Middle Int:
* Last name:
* Address:
* Zip:
* City:
 * State:
Cell:
* Phone:
Email:
* Date Available for work:
Kind of work desired:
Salary or pay expected:
Location desired:
List job benefits other than
wages you expect or want in
order of importance:
Describe your prior experience
in the kind of work you want:
Describe formal schooling or
training for this type of work:
List any licenses or certificates
you may have:
List any special skills you may
have (typing, machine
operation, etc.):
What made you decide to
apply with Marketplace Foods?
Availability for Work
***Note: Please indicate conditions you prefer or would accept and other information by selecting
“Yes” or “No” in every blank in the next 4 section: ***
* Type of Work:
Yes
 No
Part Time Less than 32 hrs:
Yes
 No
Part Time More than 32 hrs:
Yes
 No
Temporary / Short term:
Yes
 No
Long term:
* Shifts or times you will work:
Yes
 No
Day:
Yes
 No
Afternoon:
Yes
 No
Overnights:
Yes
 No
Rotating:
* Days of the week available:
Sun
 Mon
 Tue
 Wed
Thur
Fri
 Sat
 Holidays
Yes
 No
*Will you work daily overtime on
occasion if necessary?
Yes
 No
*Will you work extra days of the
week if necessary?
Yes
 No
*Do you plan to work elsewhere or
attend school while working here?
*Do you have any continuing
military obligation such as National
Guard or Reserve, which might
affect your work schedule?
 Yes
 No
Present Employment
Yes
 No
*Are you presently employed?
Yes
 No
*Do you have to give advance
notice to your present employer?
Yes
 No
*Do you have friends or relatives
working for this company?
Who?
Prior Events
Yes
 No
 When?
*Have you ever worked for or applied to
work at this company before?
Yes
 No
*Have you ever been discharged from a
job?
Yes
 No
*Have you ever been indicted or convicted
of a law violation? (a criminal background
does not automatically bar employment)
Other Personal Data
Yes
 No
*This company will hire U.S. citizens and aliens lawfully
authorized to work in the U.S.. Do you qualify?
Yes
 No
*If employed can you provide proof of U.S. citizenship
and identify, or if an alien, proof of authorization to
work in the U.S. and proof of identity?
1)
* Address:
* Employer:
* To:
 * Leaving pay:
* Starting Wage:
* From:
* Main duties :
What did you like about this job?
Why did you leave?
* Supervisor's Name:
 * Phone:
2)
* Employer:
 * Address:
* To:
 * Leaving pay:
* Starting Wage:
* From:
* Main duties :
What did you like about this job?
Why did you leave?
* Supervisor's Name:
 * Phone:
3)
* Address:
* Employer:
* To:
 * Leaving pay:
* Starting Wage:
* From:
* Main duties :
What did you like about this job?
Why did you leave?
* Supervisor's Name:
 * Phone:
Questions, comments, or feedback: