Online Application

Employment Application for: Eurofresh Market, 130 W. Northwest Highway, Palatine, IL 60067

Personal Information
Name
  first last middle
Present Address
  street city state zip
Permanent Address
  street city state zip
Contact Info
  phone number (ex:555-555-1234) email (not required)
Drivers License
(if applicable to position) driver's license number state
Emergency
(in case of emergency notify) name phone number(ex:555-555-1234)

Employment Desired
Position

date you can start

salary desired

Are you employed now?  
If so, may we inquire of your present employer?
Ever applied at this company before?
Where?

When?

Referred By

Are you over 18 years or older?

Are you prevented from lawfully becoming employed in this country because of visa or immigration status?

Have you ever pled "guilty", "no contest", or been convicted of a crime, other than minor traffic violations?
If yes, give dates and details:
Answering "yes" to this question does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.

U.S. Military or Naval Service

Rank

Present Membership in National Guard or Reserves?


Availability

Fill out all the times in which you are available. If you are not available fill in N/A. All feilds MUST be filled out.

Sun:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:



Education
  Name and Address of School # of years Graduate? Subjects Studied
Grammar School name:
addr:
High School name:
addr:
College name:
addr:
Trade, business, or correspondence school name:
addr:

Former Employers (List below last three employers, starting with last one first.)
Dates Name of Employer Position Reason for leaving
from:
to:   
(mm/dd/yyyy)

addr:
city:
state:

salary:
from:
to:   
(mm/dd/yyyy)

addr:
city:
state:

salary:
from:
to:   
(mm/dd/yyyy)

addr:
city:
state:

salary:
Which of these jobs did you like the best?

What did you like most about this job?


References Give the names of 3 people not related to you. Whom you have known at least one year.
Name Address Business Years Acquainted

city:    state: 

city:    state: 

city:    state: 

"I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATION ARE DICOVERED, MY APPLICATION MAY BE REJECTED. AND IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.
IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT ANY TIME AT EITHER MY OR THE COMPANY'S OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITION OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME BY THE COMPANY. I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAT IT'S PRESIDENT AND THEN ONLY WHEN IN WRITING AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER IN TO MY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME OR TO MAKE ANY AGREEMENT TO CONTRARY TO THE FOREGOING."


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