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Application for Employment

Questions marked with an asterisk (*) are required.
Please consider printing a copy of this page for your records before you click Submit.


Personal Information

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Country:
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* State or Province:
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Yes     No 

 
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Yes     No 

 
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Yes     No 

 

Application Information

*    Full-time work (30-40 hours per week)
   Part-time work (below 30 hours per week)
   Temporary work
 

Please indicate the hours you are available to work (Examples: 10am to 5pm, 2pm to 9pm) by day of the week.

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Yes     No 

* Earliest date you can begin employment:       mm-dd-yyyy
  Select the positions you are applying for:
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First Choice
Second Choice
Third Choice
 
 
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Yes     No 

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Yes     No 

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Yes     No 

 

Click here to view the job list and descriptions.  Link will open in new window.

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Yes     No 

 
 
 

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

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Yes     No 

 
 
 

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Education Information

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Yes     No 

 

Work History

 

List your last four employers, starting with the most recent.  Please complete this section even if you attach a resume.

 

Current or Most Recent Employer
 

   Employer Name:
   Position Title:
   Job Duties:
   Salary/Wage:
   Start Date: mm-dd-yyyy
  End Date: mm-dd-yyyy
   Reason for leaving:
   Mailing Address:
  Mailing Address (cont.):
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
   Supervisor:
  Supervisor's E-mail Address:
 

Yes     No 

 

Previous Employer

   Employer Name:
   Position Title:
   Job Duties:
   Salary/Wage:
   Start Date: mm-dd-yyyy
  End Date: mm-dd-yyyy
   Reason for leaving:
   Mailing Address:
  Mailing Address (cont.):
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
   Supervisor:
  Supervisor's E-mail Address:
 

Yes     No 

 

Previous Employer

   Employer Name:
   Position Title:
   Job Duties:
   Salary/Wage:
   Start Date: mm-dd-yyyy
  End Date: mm-dd-yyyy
   Reason for leaving:
   Mailing Address:
  Mailing Address (cont.):
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
   Supervisor:
  Supervisor's E-mail Address:
 

Yes     No 

 

Previous Employer

   Employer Name:
   Position Title:
   Job Duties:
   Salary/Wage:
   Start Date: mm-dd-yyyy
  End Date: mm-dd-yyyy
   Reason for leaving:
   Mailing Address:
  Mailing Address (cont.):
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
   Supervisor:
  Supervisor's E-mail Address:
 

Yes     No 

 
 
 

Yes     No 

 
 

Yes     No 

     Excel
   G-mail / Google Apps
   Other
   Word / Microsoft Office
 
Upload a .pdf, .doc, .docx, .rtf, .odt,
.jpg, .png, .wps, or .txt file less than 2MB.

References

 

List below three persons not related to you who have knowledge of your work performance within the last three years. (School, volunteer organizations or extracurricular interests are acceptable if no other work references are available.) 

You only need to enter Name, Relationship, Length of Time Known and Phone.

 

First Reference:

   Name:
   Occupation:
   Relationship:
   How long have you known this person?
   Mailing Address:
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
  E-Mail Address:
 

Second Reference:

   Name:
   Occupation:
   Relationship:
   How long have you known this person?
   Mailing Address:
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
  E-Mail Address:
 

Third Reference:

   Name:
   Occupation:
   Relationship:
   How long have you known this person?
   Mailing Address:
   City:
   State or Province:
   Zip or Postal Code:
   Phone:
  E-Mail Address:

Interests and Knowledge

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Certification/Authorization

 

Please read carefully, initial each paragraph and sign below:

 

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

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I hereby authorize Sacramento Natural Foods Co-op to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to Sacramento Natural Foods Co-op any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Sacramento Natural Foods Co-op, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

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I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Sacramento Natural Foods Co-op. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Sacramento Natural Foods Co-op, and that no promises or representations contrary to the foregoing are binding on the Sacramento Natural Foods Co-op unless made in writing and signed by me and the Sacramento Natural Foods Co-op’s designated representative.

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This application is current and active for 90 days from date that it is turned into the Co-op.

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Date:

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