Conner’s Supermarket

At Conner’s Supermarket we strive to hire the best help available.  We have excellent benefits including a comprehensive Blue Cross Blue Shield plan, Retirement plan, flexible hours, and  happily employ workers year round.  Please fill out an application and give it to Angie or Becky, if they are unavailable please leave the application with the cashiers. Thanks for your interest

Text Box: CONNER'S SUPERMARKET 

EMPLOYMENT APPLICATION

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

(PLEASE PRINT ALL RESPONSES)

 

DATE:__________________SOCIAL SECURITY #__________________________

NAME:______________________________________________________________

ADDRESS:___________________________________________________________

PHONE:_____________________________________________________________

 

TYPE OF POSITION DESIRED:_________________________________________

FULL TIME, PART TIME, OR TEMPORARY:______________________________

PLEASE INSERT TIMES ON EACH DAY YOU WOULD BE AVAILABLE FOR WORK.

MON._____ TUES._____ WED._____ THURS._____ FRI._____ SAT. _____ SUN._____

HOW SOON WOULD YOU BE AVAILABLE FOR WORK:_____________________

SALARY REQUIRED:____________________

 

ARE YOU 16 OR OLDER:____________ ARE YOU 18 OR OLDER:____________

 

PRIMARY LANGUAGE – ENGLISH _____  OTHER________________________

 

ARE YOU ABLE TO LIFT 25LBS:______  50LBS:______

 

HAVE YOU EVER BEEN CONVICTED OF A CRIME? YES____ NO____

IF YES, GIVE FULL PARTICULARS:_____________________________________

 

 

 

FOR EACH TYPE OF SCHOOL YOU HAVE ATTENDED, PLEASE LIST THE SCHOOLS NAME, THE LAST YEAR YOU COMPLETED, AND INDICATE IF YOU GRADUATED

 

GRADE SCHOOL:_____________________________________________________

HIGH SCHOOL:_______________________________________________________

COLLEGE:___________________________________________________________

BUSINESS OR TRADE SCHOOL:________________________________________

SPECIAL TRAINING:__________________________________________________

WHAT TYPES OF BUSINESS MACHINES DO YOU OPERATE?______________

HAVE YOU EVER BEEN DISCHARGED FROM ANY POSITION? YES____ NO____

IF YES, EXPLAIN:_____________________________________________________

 

EMPLOYMENT EXPERIENCE / WORK HISTORY

START WITH YOUR PRESENT OR YOUR LAST EMPLOYER.  IF YOU NEED MORE SPACE, USE AN EXTRA SHEET OF PAPER.  IF SUMMER OR PART TIME WORK, PLEASE INDICATE.  

 

NAME OF EMPLOYER:________________________________________________

TYPE OF BUSINESS:__________________________________________________

CITY & STATE:______________________ PHONE:_________________________

SUPERVISOR/TITLE:_________________________________________________

STARTING DATE:________________ LEAVING DATE:_____________________

STARTING PAY:_________________ LEAVING PAY:_______________________

YOUR TITLES AND DUTIES:___________________________________________

_____________________________________________________________________

REASON FOR LEAVING:_______________________________________________

 

NAME OF EMPLOYER:________________________________________________

TYPE OF BUSINESS:__________________________________________________

CITY & STATE:______________________ PHONE:_________________________

SUPERVISOR/TITLE:__________________________________________________

STARTING DATE:________________ LEAVING DATE:______________________

STARTING PAY:_________________ LEAVING PAY:________________________

YOUR TITLES AND DUTIES:___________________________________________

_____________________________________________________________________

REASON FOR LEAVING:_______________________________________________

 

NAME OF EMPLOYER:_________________________________________________

TYPE OF BUSINESS:___________________________________________________

CITY & STATE:______________________ PHONE:__________________________

SUPERVISOR/TITLE:___________________________________________________

STARTING DATE:________________ LEAVING DATE:______________________

STARTING PAY:_________________ LEAVING PAY:________________________

YOUR TITLES AND DUTIES: ___________________________________________

______________________________________________________________________

REASON FOR LEAVING ________________________________________________

 

ARE WE GRANTED PERMISSION TO CHECK ALL INFORMATION? YES____ NO____

EMPLOYERS WHOM YOU DO NOT WISH US TO CONTACT?______________________________________________________

 

I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION` IS CORRECT TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT DELIBERATE FALSIFICATION OF THIS INFORMATION IS GROUNDS FOR DISMISSAL IN ACCORDANCE WITH THIS COMPANY'S POLICY.

 

SIGNATURE OF APPLICANT:_____________________________DATE:______________

Conner’s Supermarket

PO Box 71

47468 Highway 12

Buxton, NC 27920-0071

Phone:    (252) 995-5711

Fax:         (252) 995-5779

E-mail: conners5@embarqmail.com