Sidney                                                                                                                                                                         
FOODTOWN                                                     
                                                                APPLICATION FOR EMPLOYMENT             

All portions of this application pertaining to you must be completed.  We appreciate the time you will spend in completing this application.  It is the policy
and practice of this Company to provide all qualified employees and applicants for employment with equal employment opportunities without regard to age,
race, religion, color, sex, pregnancy, ancestry, national origin, disability, or any other status or condition protected by applicable law.  We will provide, upon
request, reasonable accommodations to assist applicants with disabilities in applying for employment.
Name: (Last, First Middle)
Phone number:
Address
Email address:
City, State, Zip
Social Security No.
Are you legally entitled to work in the United States
Yes
Part-Time
Full-Time
Type of employment
Have you ever worked for this company before
Yes
Temporary
The position you are applying for is
Monday.
Wednesday
Tuesday
Sunday
Thursday
Saturday
Friday
Availability
AM. -  PM.
Is your Current age at least 16 years or older?
Is your Current age at least 18 years or older?
Yes
Yes
Highest grade completed
GED
College
High School
Employment Record (Please list the most recent first)
Employer Name, Address, and Phone
Reason for leaving
Salary
Employment Dates
May we call them?
Yes
______________________________________________________________________________________________________________________________
Employer Name, Address, and Phone
Salary
May we call them?
Yes
Reason for leaving
Employment Dates
______________________________________________________________________________________________________________________________
Employer Name, Address, and Phone
Reason for leaving
Yes
Salary
May we call them?
Employment Dates
Comments
Date