Job Application for
Cub Foods-Buffalo
The Marketplace-Annandale and Cokato

Back

Employment Application

We appreciate your interest in Cub Foods/The Marketplace. This information will help us understand your qualifications, background, and work history and will help us place you in a position for which you are best suited.

The Civil Rights Act of 1964, the Age Discrimination in Employment Act, and the American with Disabilities Act, as amended, prohibit discrimination in employment because of race, color, sex, religion, natural origin, age or disability. Various state laws prohibit some of the above as well as other types of discrimination. As an Equal Opportunity Employer, Cub/The Marketplace intends to comply fully with all applicable employment laws.

PERSONAL INFORMATION DATE

Last Name First Name Middle Initial Social Security No.
Street Address County
City or Town State Zip Code Home Phone
Phone where you can be reached if different from home Phone Number & Area Code Extension

 

POSITION INFORMATION

Position(s) Applying For Status Desired
Full Time  Part Time  Temp
Expected Earnings Location Preference
Do you have the ability to perform the essential functions of the job you are applying for with or without reasonable accommodation? Yes   No
If an accommodation is needed, state how you would perform these tasks and with what accommodation(s):

SCHEDULE AVAILABILITY

TIME: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
From When?
To When?

*Please note that the above designations do not guarantee specific work shifts.

EDUCATION INFORMATION

School Type School Name and Location Dates Attended Degree or grade completed Major Field of Study
High School/

GED

 

College/

University

 
Graduate

School

 
Business,

Trade, Other

 
List any special skills, training, professional licenses/registration or qualifications you have that qualify you for the position(s) you are applying for:

GENERAL INFORMATION
Are you legally eligible for employment in the United States? Yes No
Are you at least 18 years old? Yes No If no, how old are you?
Have you ever been convicted of a crime? (A conviction will not necessarily disqualify you from employment) Yes No
If yes, explain:
How were you referred to this company?
Please list any people you know who are currently employed by this company:
Have you worked for this company before? Yes No If yes, when? Where?
Reason for Leaving:

 

EMPLOYMENT HISTORY

Present or most recent employer

Name of Company Type of Business
Address – Street City State Zip
Employment Dates (Month/Year) Supervisor’s Name Title Phone Number May we contact?
Yes No
Position Title Brief Description of Job
Starting Rate of pay Ending Rate of Pay Bonus, Incentives, etc. Reason for Leaving
Amount Year

 

Next Previous Employer

 

Name of Company Type of Business
Address – Street City State Zip
Employment Dates (Month/Year) Supervisor’s Name Title Phone Number May we contact?
Yes No
Position Title Brief Description of Job
Starting Rate of pay Ending Rate of Pay Bonus, Incentives, etc. Reason for Leaving
Amount Year

 

Next Previous Employer

Name of Company Type of Business
Address – Street City State Zip
Employment Dates (Month/Year) Supervisor’s Name Title Phone Number May we contact?
Yes No
Position Title Brief Description of Job
Starting Rate of pay Ending Rate of Pay Bonus, Incentives, etc. Reason for Leaving
Amount Year

 

REFERENCES

Name (not relative) Occupation Phone Number Length of Time Known

MILITARY SERVICES
Branch of Service Dates of Service Rank at Discharge

Type of Discharge* Special Training

*A dishonorable or general discharge is not an absolute bar to employment

READ THE FOLLOWING CAREFULLY, THEN TYPE NAME AND DATE APPLICATION

The information I have provided on this application is true and correct to the best of my knowledge. Any false statement or omission of facts will be justification for refusal of employment, or if employed, termination of employment. Cub/The Marketplace may verify all the information provided by me, including but not limited to education and employment, and may use an outside company to conduct the investigation. I understand that if I become employed by Cub/The Marketplace, my employment is for no specific term. I further understand my employment is terminable, with or without notice, at the will of either myself or the company.

 

Applicant’s Signature Date