Employment Application
Email *
Today's Date *
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Name
First MI Last
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Preferred Name/Nickname
Preferred Pronoun/s
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Street Address
City, State, Zip Code
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Phone Number /Alternate Phone Number  *
Email Address *
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What schedules do you prefer? 
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How did you hear about us?
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Have you worked at this company before? *
Do you know anyone that works here? *
Desired Pay: Hourly $ *
When are you able to start? *
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Desired Position: *
Please check yes or no to the following:
Are you authorized to work in the united states?
Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with these laws, Spiral Food Co-op will verify the status of every individual offered employment with the Company. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identification and employment
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Are you under 18? *
If yes can you furnish a work permit?
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Are you capable of performing the essential functions of the job for which you are applying with or without a reasonable accommodation?
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Please list your work experience below (most recent first)
Company Name:
Your position/Title
Dates employed From:
Month/year to month/year
Supervisors Name, Position/Title
Street #
City, State, Zip Code
Type of business 
Phone number
Termination
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Reason
Briefly describe your major duties:
Work experience (second most recent)
Company name: 
Your position/Title
Dates employed From:
Month/year to month/year
Supervisors Name, Position/Title
Street #
City, State, Zip Code
Type of business 
Phone number
Termination
Clear selection
Reason
Briefly describe your major duties:
Work experience (third most recent)
Company name:
Your position/Title
Dates employed From:
Month/year to month/year
Supervisors Name, Position/Title
Street #
City, State, Zip Code
Type of business 
Phone number
Termination
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Reason
Briefly describe your major duties:
Education
Name of school
Highschool:
 *
Did you graduate? *
Education
Name of School
College:
Did you graduate?
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Type of degree or diploma:
Education
Name of school
Other:
Did you graduate?
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Type of degree or diploma
References
please list 3 professional references
Name:
Relationship:
Company:
Phone number:
Reference 2
Name:
Relationship:
Company:
Phone number:
Reference 3
Name:
Relationship:
Company
Phone number:

PLEASE READ CAREFULLY BEFORE SIGNING APPLICATION


I have submitted the attached form to the company for the purpose of obtaining employment. I acknowledge that the use of this form, and my filling it out, does not indicate that any positions are open, nor does it obligate the company to further process my application.  


My signature below attests to the fact that the information that I have provided on my application, resume, given verbally, or provided in any other materials, is true and complete to the best of my knowledge and also constitutes authority to verify any and all information submitted on this application. I understand that any misrepresentation or omission of any fact in my application, resume or any other materials, or during any interviews, can be justification for refusal of employment, or, if employed, termination from the Company’s employ.  

I also affirm that I have not signed any kind of restrictive document creating any obligation to any former employer that would restrict my acceptance of employment with the Company in the position I am seeking.  


I understand that this application is not an employment contract for any specific length of time between the Company and me, and that in the event I am hired, my employment will be “at will” and either the Company or I can terminate my employment with or without cause and with or without notice at any time. Nothing contained in any handbook, manual, policy and the like, distributed by the Company to its employees is intended to or can create an employment contract, an offer of employment or any obligation on the Company’s part. The Company may, at its sole discretion, hold in abeyance or revoke, amend or modify, abridge or change any benefit, policy practice, condition or process affecting its employees.


References: I hereby authorize the company and its agents to make such investigations and inquiries into my employment and educational history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquires connected with my application and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities listed by me in this form. Furthermore, I authorize the company and its agents to release any reference information to clients who request such information for purposes of evaluating my credentials and qualifications.


Temporary/Contract Employment: If employed as a temporary or contract employee, I understand that I may be an employee of the company and not of any client. If employed, I further understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason. I further understand that a contract will exist between the company and each client to whom I may be assigned which will require the client to pay a fee to the company in the event that I accept direct employment with the client, I agree to notify the company immediately should I be offered direct employment by a client (or by referral of the client to any subsidiary or affiliated company), either for a permanent, temporary (including assignments through another agency), or consulting positions during my assignment or after my assignment has ended.

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