Employment Application

VERMONT’S LONGEST RUNNING STORE. IN THE HEART OF JERICHO CENTER SINCE 1807!

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*We’re always looking for great people to join our team! We’re often in need of cashiers, deli & grill team members, and more! Apply below!*

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Applicant Information

*Full Name:

*Date:

*Address

*Street Address:

*Apartment/Unit #:

*City:

*State:

*Zipcode:

*Phone:

*Email:

*Date Available:

*Desired Salary:

*Position Applied for:

*Are you a citizen of the United States?

Yes No

*If no, are you authorized to work in the U.S.?

Yes No

*Have you ever worked for this company?

Yes No

*If yes, when?

*Have you ever been convicted of a felony?

Yes No

*If yes, explain:

*Available weekends and holidays?

(applicants will NOT be considered if unavailable during weekends and minor holidays.)

Education

*High School:

*Address:

*From:

*To:

*Did you graduate?

Yes No

*Diploma:

*College:

*Address:

*From:

*To:

*Degree:

References

*Full Name:

*Relationship:

*Company:

*Phone:

*Address:

*seperator

*Full Name:

*Relationship:

*Company:

*Phone:

*Address:

*seperator

*Full Name:

*Relationship:

*Company:

*Phone:

*Address:

Previous Employment

*Company:

*Phone:

*Address:

*Supervisor:

*Job Title:

*Starting Salary:

*Ending Salary:

*Responsibilities:

*From:

*To:

*Reason for Leaving:

*May we contact your previous supervisor for a reference?

Yes No

*seperator

*Company:

*Phone:

*Address:

*Supervisor:

*Job Title:

*Starting Salary:

*Ending Salary:

*Responsibilities:

*From:

*To:

*Reason for Leaving:

*May we contact your previous supervisor for a reference?

Yes No

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.

*Signature:

*Date:

Fields with (*) are compulsory.

MONDAY – FRIDAY 7am – 7pm
SATURDAY 8am – 7pm
SUNDAY 8am -6pm

(802) 899-3313
[email protected]

25 Jericho Center Circle
PO Box 1039
Jericho Center, VT 05465

Website by Breezy Hill Marketing

Home
ABOUT US
Gallery
CONTACT US/WORK WITH US!
Order Online