LFM EMPLOYMENT APPLICATION *

Living Fresh Market

We are an equal employment opportunity employer. We do not discriminate on the basis of race, color, creed, religion, ancestry, marital status, gender, gender identity, pregnancy, sex, sexual orientation, national origin, political affiliation, military status, age, or mental/physical disability, or any other protected status in accordance with applicable federal, state, and local laws.
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position applied for
Desired Salary

Availability Schedule

Education
High School
High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Did you Graduate?
College
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Degree
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Did you Graduate?
Program
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Degree/Certificate
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Did you Graduate?

Professional References
Name

First NameLast Name
Relationship
Company
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name

First NameLast Name
Relationship
Company
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Previous Work Experience
Company
Supervisor
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Starting Salary
Ending Salary
Responsibilities
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Leaving
May we contact your previous supervisor for a reference?
Company
Supervisor
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Starting Salary
Ending Salary
Responsibilities
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Leaving
May we contact your previous supervisor for a reference?
Have you ever been terminated or asked to resign from any job?
If Yes, Please explain the circumstances
Have you ever served in the military?
Branch
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Rank at Discharge
Type of Discharge
If other than honorable, please explain.
Should be Empty: