Jake's Market & Deli Employment Application
Sign in to Google to save your progress. Learn more
Applicant Full Name: *
Date of Application: *
Home Street Address: *
City/State/ZIP: *
Phone Number: *
E-Mail: *
Social Security Number: *
What position are you applying for? *
Please specify location of position
Clear selection
Full or Part Time? *
Which shifts are you able to work? Please select all that apply.
List any scheduling limitations (ie. days required off)
Who referred you to our company?
Do you have any friends or relatives who work here? If yes, please list below:
Have you worked at Jake's previously? If yes, when and where? *
Are you at least 18 years old? *
If you are offered employment, when would you be available to begin work? *
If hired, are you able to submit proof that you are legally eligible for employment in the United States? *
Are you able to perform the essential function of the job position you seek with or without reasonable accommodation? *
What reasonable accommodation, if any, would you require?
Have you ever been convicted of a felony? *
If yes, please list your conviction, the date you were convicted, and in what city/state you were convicted.
List any skills that may be useful for the job you are seeking along with the number of years of experience, and rate your ability for each skill 1-5 with 1 being poor ability and 5 being exceptional ability. *
REQUIRED: Please list your employment history for the last 2 years beginning with the most recent job:
- NAME OF YOUR EMPLOYER
- SUPERVISOR'S NAME
- CITY/STATE
- POSITION 
- REASON FOR LEAVING
- DATES OF EMPLOYMENT (month/years) 
 *
Did you graduate from High School or receive your GED? *
Did you graduate from College/University? If yes, what degree did you receive?
Do you have other training (graduate, technical, vocational)? *
Please list 3 NON-RELATIVES who would be willing to provide a reference for you. Include their NAME, PHONE NUMBER, and YEARS KNOWN: *
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize Sugar Face & Company, LLC & KB Ventures, Inc. to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. If any employment is offered I understand the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause, except as may be required by law.With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the same right. This application does not constitute an agreement or contract for employment. I understand if I'm hired I will be required to provide proof of identity and legal work authorization. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS. Please digitally sign and date below: *
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This content is neither created nor endorsed by Google.