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Job Application

* Required Field

Applicant Information

Name(Required)
Address(Required)
(###)###-####
Position(s) Applying For(Required)
(be specific – max 3)
MM slash DD slash YYYY
Are you a United States Citizen?
If no, are you authorized to work in the US?(Required)
Have you ever worked for this company?
Are you over the age of 18?
May we perform a background check on you?(Required)

Availability

List approximate times available next to each day. (ex. Monday: 3pm to 10pm)

Education

Address
Did you graduate?

Address
Did you graduate?

Address
Did you graduate?

References

Name
Address

Name
Address

Name
Address

Employment History

Please list all present and past employers. Begin with your most recent.
Address
Please enter salary range. Starting and end salary.
MM slash DD slash YYYY
MM/DD/YYYY
MM slash DD slash YYYY
MM/DD/YYYY

Address
Please enter salary range. Starting and end salary.
MM slash DD slash YYYY
MM/DD/YYYY
MM slash DD slash YYYY
MM/DD/YYYY

Address
Please enter salary range. Starting and end salary.
MM slash DD slash YYYY
MM/DD/YYYY
MM slash DD slash YYYY
MM/DD/YYYY

Military Service

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
MM slash DD slash YYYY

Our Address

Ed and Jeans Market
95 Rochester St
Port Byron, NY 13140

Our Phone Number

(315) 776-5511

Company Logo

Our Store Hours

Mon: 5:00am - 9:00pm
Tue: 5:00am - 9:00pm
Wed: 5:00am - 9:00pm
Thu: 5:00am - 9:00pm
Fri: 5:00am - 9:00pm
Sat: 5:00am - 9:00pm
Sun: 5:00am - 9:00pm

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