New Job Application Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail

example@example.com

Phone Number*

Years at Current Residence:*

Are you legally authorized to work in the U.S.?*

YesNo

Available start date:*

Date

Store Location to which you are applying:*

Have you applied here before?*

YesNo

When?*

Have you ever worked for any Leprekon Harvest Foods store before:*

YesNo

Dates of employment and in what position and location:*

Do you currently have relative(s) employed with Leprekon Harvest Foods:*

YesNo

Please give their names:*

Are you at least 21 years of age?*

YesNo

Date of Birth:*

Do you have a current Washington State Food Worker's Card? (Required for employment)*

YesNo

When does your food Workers card expire?*

What position are you applying for?

Please list any relevant skill or job qualification related to the job you are applying for:

What type of position are you seeking?*

Part-timeSeasonalFull-timeTemporary

Check if you are willing to accept regular work on: (Check all that Apply.)*

Please list any days and times you are unable to work:

Any prior commitments which would require an absense of more than 2 days in the next 6 months?*

YesNo

If yes, please provide more information:*

Are you now, or do you expect to be engaged in any other business or employment?*

YesNo

If yes, please explain:

Are you able to work more than 25 hours per week?*

YesNo

Are you able to work less than 25 hours per week?*

YesNo

	School Name, City, State	Graduated Yes/NO	Degree & Major	GPA
High School
College/Uni.
College/Uni
Trade/Other

Scholastic honors achieved:

Are you currently a student?*

YesNo

If yes, school name, course of study and portion completed:*

Outside activities while in school which you feel reflect your abilities:

Plans for future education/training:

May we contact employer?

YesNo

Company:

Address:

Job Title:

Supervisor:

Phone #:

Date Started:

Date Left:

Reason for leaving:

May we contact employer?

YesNo

Company:

Address:

Job Title:

Supervisor:

Phone #:

Date Started:

Date Left:

Reason for leaving:

May we contact employer?

YesNo

Company:

Address:

Job Title:

Supervisor:

Phone #:

Date Started:

Date Left:

Reason for leaving:

Name:

Relation:

Phone #:

Residence (Town):

Years Known:

Name:

Relation:

Phone #:

Residence (Town):

Years Known:

Upload Resume

Basic Required Job Description

Essential Physical Requirements:

Ability to stand on feet for 8-hour shift.

Ability to move or handle merchandise throughout the store weighing up to 50 pounds.

Frequently reach, bend, stoop, loft, shake, stir, pour, carry, and push.

Repetitive motions of the wrist, hand, and fingers.

Must be able to use the telephone and intercom in a professional manner.

Ability to communicate with team members and customers.

And other duties as may be assigned by management.

Ability to work varied hours and days as business dictates.

Maintain a clean, sanitary, and safe work environment.

Responsible for assisting in training of new team members.

Ensure each customer receives outstanding customer service by greeting and acknowledging every customer.

Communicate customer requests to management.

Answer customer's questions concerning location of merchandise.

Communicate customer requests to management.

Must have the ability to work in a fast-paced environment.

Must adhere to Lep-re-kon Harvest Foods accident prevention program.

Must maintain and keep on file a current Washington State Food Handler's Card.

Participate in Lep-re-kon Harvest Foods accident prevention program by taking necessary precautions to reduce accidents.

Must communicate customer requests to management.

Applicant's Statement

I acknowledge that I am applying for employment with Lep-re-kon Harvest Foods.

I hereby affirm that the information provided on this application, and accompanying letters or resume, is true and complete.

I also agree and understand that any false or misleading information or significant omissions may disqualify me from consideration for employment or result in my dismissal if hired.

I authorize this employer to investigate my background thoroughly and agree to assist in such investigation. I release and hold harmless and promise not to claim damages from any of my prior employers listed above from providing information.

I agree to submit to any drug test that may be required by the employer. I understand that the refusal to submit to testing will result in my disqualification for employment with this organization.

I have read and understand the above basic required job description and if offered a position with Lep-re-kon Harvest Foods I am capable of performing all of the functions of this position without any physical restrictions.

I also understand that employment may be be conditioned upon investigation into criminal convictions on record with Local, State and Federal law enforcement authorities.

I understand that, if hired, my employment is not for any specific period or duration and is terminable at will by the employer or me at any time with or without cause or notice. I understand this application is NOT A CONTRACT.

I agree to present documentation proving my eligibility to work in the United States, and that failure to do so voids any offer of employment.

Applicant's Name*

Signature of Applicant

Today's date*

We are an equal opportunity employer. All qualified applicants are considered regardless of race, religion, color, age, sex, sexual orientation, gender identity, marital status, nationality, veteran status, or disability.

Please verify that you are human*

Employment Form

Education

Employment History

Recent Empoyer #1

Recent Empoyer #2

Recent Empoyer #3

References

Reference #1

Reference #2

Please read, sign, and date if you are able to perform the basic functions listed below: