Newry General Store Job Application

Full Name*

First Name (Legal)Last Name

Preferred Name

The name you go by if it is different from you legal name.

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address*

example@example.com

Phone Number*

Please Select Age Category*

Position Applied*

Are you seeking Full time or Part time?*

Full Time (30-40 hours)Part Time (10-30 hours)

How did you hear about us*

Available Start Date*

Date

Select Day and Times you are available to work.*

How many hours each week are you available to work?

Are you a U.S. Citizen or authorized to work in the United States without sponsorship.*

YesNo

If offered employment, can you provide proof of work authorization per USCIS Form I-9?*

YesNo

Have you ever been convicted of a felony?*

YesNo

Upload Your Resume*

High School

High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did you Graduate or receive GED?

YesNo

If GED, please provide state & date received GED Date & State (do not list graduation date):

College

City, State

From:

Enter Year

To:

Enter Year

Did you graduate?

YesNo

Other Education:

Ex. Serv Safe Certification

1. Name of Reference*

First NameLast Name

Relationship*

Company Name*

Email

Company Number*

Include area code

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

2. Name of Reference*

First NameLast Name

Relationship*

Company Name*

Email

Company Phone Number*

Include area code

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

3. Name of Reference*

First NameLast Name

Relationship*

Company Name*

Email

Company Phone Number*

Include area code

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

1. Company Name*

Phone Number

Please enter a valid phone number.

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor Name

Supervisor Email

Your Job Title

Responsibilities

Employed From:

Date

Employed To:

Date

Reason for Leaving

May we contact your previous supervisor for reference?

YesNo

2. Company Name

Company Phone Number

Please enter a valid phone number.

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor Name

Supervisor Email

Your Job Title

Employed From:

Date

Employed To:

Date

Reason for Leaving

May we contact your previous supervisor for reference?

YesNo

3. Company Name

Company Phone Number

Please enter a valid phone number.

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor Name

Supervisor Email

Your Job Title

Employed From:

Date

Employed To:

Date

Reason for Leaving:

May we contact your previous supervisor for reference?

YesNo

Why would you like to work here?*

I certify that my answers are true and complete to the best of my knowledge.
By submitting this application, I authorize the investigation of all statements contained in this application. I understand that misrepresentation or omission of facts is cause for dismissal at any time without notice. I authorize the investigation of all matters contained in this application and hereby give Newry General Store & Cafe (NGSC) and its designees permission to contact my schools, previous employers (unless otherwise indicated), references, and others, and I hereby release NGSC and its assigns from any liability as a result of such contact.

I understand that if I am offered and accept a position at NGSC, there is no contract of employment and employment is at will; I am not being employed for any specified time, and the submission of information is not intended to be a contract for continued employment.

I understand that this application will remain active for a period of three months. After that time, if I desire further consideration, I must renew my application.

I have carefully read the above acknowledgment and I understand and agree to all of the statements.*

Signature

Job Application

Education

Professional References

Previous Employment

Acknowledgement & Signature