Employment Application Form

Employment Application

Please answer all questions. Resumes are not a substitute for a completed application.
We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, sexual orientation, gender identification, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws.

Good Harvest Market is an at-will employer, as allowed by applicable state law.
Applicant Information
Name:*

First NameMiddle InitialLast NameSuffix
Date*

MonthDayYear
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Mobile Phone*

Area CodePhone Number
E-mail Address:*
Date available to start work*
Desired Salary $*
Position applying for *
What employment status are you seeking?*

Full TimePart TimeSeasonalTemporary
How were you referred to us?*

Walk-in/Sign on DoorGHM Website Careers PageIndeed.comFaceBook JobsFriend/Family Member*Other
*If you were referred by a current employee, list their name here (only 1 active employee can qualify for our referral hire bonus incentive):
Are you a citizen of the United States*

YesNo
If no, are you authorized to work in the U.S.?

YesNo
Have you ever worked for this company?*

YesNo
If yes, when?
Have you ever pleaded guilty, no contest, or been convicted of a crime? (Answering yes to this question does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered).*

YesNo
If yes, please give dates and details.
Education
High School*
Address
Number of years completed*
Did you graduate?*

YesNo
Diploma
College
Address
Number of years completed
Did you graduate?

YesNo
Degree
Bus./Tech./Trade or Post College:
Address
Number of years completed
Did you graduate?

YesNo
Degree
Please list any awards or certifications
Previous Employment

Please list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for the most recent ten (10) year period. If self-employed, supply your business name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Do not answer “see resume".
Current or Most Recent Employer:
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
What will this employer say was the reason your employment terminated?
May we Contact this Employer?
Next Recent Employer:
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
What will this employer say was the reason your employment terminated?
May we Contact this Employer?
Next Recent Employer:
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
What will this employer say was the reason your employment terminated?
May we Contact this Employer?
Cover Letter & Resume
Please attach resume

Upload a File

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Attach cover letter

Upload a File

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Disclaimer and Signature
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.

If hired, I agree to conform to the rules and regulations of the company, and I understand that the company has complete discretion to modify such rules and regulations at any time, except that it will not modify its policy of employment at-will.

I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state and/or local law. If applicable and allowed by law, I will receive separate written notification regarding the Company’s intent to obtain "consumer reports."

I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above- mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the company harmless for providing such information.

If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States.

This application will be considered active for a maximum of ninety (90) days. If you wish to be considered for employment after that time, you must reapply.

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE.
Signature: type your full name as acceptance the data submitted in this document is accurate and true*
Date*
Pre-Interview Q & A
Sunday Availability

AMPMNot AvailableOther
Monday Availability

AMPMNot AvailableOther
Tuesday Availability

AMPMNot AvailableOther
Wednesday Availability

AMPMNot AvailableOther
Thursday Availability

AMPMNot AvailableOther
Friday Availability

AMPMNot AvailableOther
Saturday Availability

AMPMNot AvailableOther
How flexible does your scheduling need to be? Please explain.
Rate your timeliness. 1 for never on time, 5 for always on time.
Explain your timeliness rating.
Why would you like to work at Good Harvest Market?
Rate your customer service skills. 1 being low, 5 being high.
Define good customer service.
Should be Empty:

Employment Application

Applicant Information

Education

Previous Employment

Cover Letter & Resume

Disclaimer and Signature

Pre-Interview Q & A