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

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
Date
To

MonthDayYear
Date
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
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
Date
To

MonthDayYear
Date
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
Have you ever been terminated or asked to resign from any job?

YesNo
If Yes, Please explain the circumstances
Have you ever served in the military?

YesNo
Branch
From

MonthDayYear
Date
To

MonthDayYear
Date
Rank at Discharge
Type of Discharge
If other than honorable, please explain.
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Should be Empty:

Living Fresh Market