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 *
Full Name
Alternate Phone
Zip Code
Restrictions or special requirements
Check any positions you would NOT be willing or able to work.
Maximum hours per week (optional)
Minimum hours per week (optional)
I can provide a valid driver's license.
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If necessary for the job, I am older than:
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Are you seeking a temporary position?
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After being notified of being hired, I will be available to work:
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Add: Name of institution, years completed, field of study, level of completion (add multiple lines)
Skills & Qualifications
Add any skills, abilities, honors, certifications, licenses, experience, volunteering, etc.
Employment History
Add: Employer name, position, start-end date, reason for leaving, supervisor name and contact information (add multiple lines)
Personal References (other than relatives and former supervisors)
Add: name, contact information, occupation, years known (try to list at least two)
Emergency Contact
In case of accident or illness, please contact (list name, contact information, relationship to that person):
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:
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