Personal Information: Email: First Name:
Last Name:
Middle Name:
Address: Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Are you at least 18 years old? How did you hear we were hiring?
Employment Desired: Position:
Date Available to Start:
Salary Desired:
Store: Not Relevant Burr Ridge Darien Mokena
Department: General Bakery Carts Cashier Customer Service Dairy Deli Frozen Grocery Kitchen/Catering Liquor Management Meat Pricing Produce Receiving Seafood
Availability: Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
What is the maximum amount of hours you can work per week?
What is the number of hours you prefer work per week?
To better serve our customers, do you speak any other languages other than English? (list all)
Prefer not to answer
Have you ever applied to Brookhaven Marketplace before? Where?
When?
Education: Employment Experience: (Please list your employment experience, starting with the most recent first.)
Are you currently employed? If yes, may we contact your current employer? Boar's Head Café will only contact current employer only if you consent. Our Company reserves the right to contact the other employers listed without any further notice to you.)
Dates of EmploymentMonth & Year
Employer Name
General Information: Subject Of Special Study / Research Work Or Special Training / Skills
Do you have Military Experience? If yes, what was your position and who was your supervisor?
References: PLEASE READ CAREFULLY BEFORE SIGNING I certify that all the information submitted by me on this application is true, correct and complete. I understand that if any false information, omissions, or misrepresentations on this form or provided in any interview are discovered, my application may be rejected, and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company’s rules, regulations and Supervisor’s directions. I understand that this Application for Employment and other Company documents are not contracts of employment. I agree that if I am employed, my employment is at-will, and that my employment, compensation or benefits can be changed or terminated, with or without cause or reason, and with or without notice, at either my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause or reason, and with or without notice, at any time by the company. I understand that no company representative, other than the President, and then only in writing and signed by both of us, has any authority to enter into any agreement for employment for any specific period of time or to make any agreement contrary to the forgoing. I further authorize the Company to investigate my references, personal history, work record, and other matters related to my suitability for employment, as well as credit or criminal records checking. I authorize all of this information to be provided to the company or their agent and release them from any and all claims, demands or liability arising out of or in any way related to such investigation or disclosure. I understand that if hired, I may be required to pass a criminal history records check. Also, if required, I agree to complete, fully participate in and pass a drug and/or alcohol test. Please note that this application is considered current for 30 days. After 30 days, it is necessary to complete another application form to be considered for employment.
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