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Employment Application
Summit Country Market, Phone: 814-634-1735
You must be legally eligible to work in U.S. to be considered for employment. You will be required to show proof of eligibility.
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Email
*
Your email
Full Name
Your answer
Phone
Your answer
Alternate Phone
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Restrictions or special requirements
Your answer
Check any positions you would NOT be willing or able to work.
Deli sales: Must be 18 years or older; requires standing, operating a slicer
Cashier
Stocker: Requires lifting (10 - 40 lbs)
Frozen and Refrigerated food sales: Requires lifting (10 - 40 lbs), cold temperatures
Other:
Maximum hours per week (optional)
Your answer
Minimum hours per week (optional)
Your answer
I can provide a valid driver's license.
Yes
No
Clear selection
If necessary for the job, I am older than:
14
15
16
18
19
21
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Are you seeking a temporary position?
Yes
No
Other:
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After being notified of being hired, I will be available to work:
immediately
in 1 day
in 1 week
in 2 weeks
Other:
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Education
Add: Name of institution, years completed, field of study, level of completion (add multiple lines)
Your answer
Skills & Qualifications
Add any skills, abilities, honors, certifications, licenses, experience, volunteering, etc.
Your answer
Employment History
Add: Employer name, position, start-end date, reason for leaving, supervisor name and contact information (add multiple lines)
Your answer
Personal References (other than relatives and former supervisors)
Add: name, contact information, occupation, years known (try to list at least two)
Your answer
Emergency Contact
In case of accident or illness, please contact (list name, contact information, relationship to that person):
Your answer
Verification
*
As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. I certify that I am legally eligible for employment in the U.S., and I understand and agree to the information shown above:
Yes
No
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