MacFood Mart Employment Application

Your Name (required)

Your Phone (required)

Your Email (required)

Your Address (required)

How were you referred to MacFood Mart?

Position(s) applying for:

Location applying for:
BrookwoodGoshen RoadRoyvilleWayne Haven

Are you applying for:
Temporary work (e.g. summer or holiday work)?
YesNo
Regular part-time work?
YesNo
Regular full-time work?
YesNo

What days and hours are you available to work?

If applying for temporary work, when will you be available?

If hired, what date can you start working?

Are you available to work overtime?
YesNo

Salary desired (per hour):

Have you ever applied to/worked for this company before?
YesNo

If yes, please explain (include date):

Do you have any friends, relatives, or acquaintances working for this company?
YesNo

If yes, state name and relationship:

If hired, would you have reliable transportation to and from work?
YesNo

Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age.)
YesNo

Are you over the age of 21? (Alcohol is sold at certain locations.)
YesNo

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?
YesNo

If hired, are you willing to submit to and pass a controlled substance test?
YesNo

Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation?
YesNo

If no, describe the functions that cannot be performed:

(Note: Company complies with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)

Have you ever been convicted of a criminal offense (felony or misdemeanor)?
YesNo

If yes, please describe the crime – state nature, when and where convicted and disposition of the case:

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied may, however, be considered.)

Personal references – provide name, phone, and relationship:
Reference 1

Reference 2

Reference 3

High school:
School name:

School city/state:

Years completed:

Did you graduate?
YesNo

College/university:
School name:

School city/state:

Years completed:

Did you graduate?
YesNo
Degree/diploma earned:

Vocational school:
School name:

School city/state

Years completed:

Did you graduate?
YesNo
Degree/diploma earned:

Military:
Branch:

Rank in military:

Total years service:

Skills/duties:

Related details:

Employment Experience
(most recent first)

Employer:

Address:

Phone number:

Supervisor’s name:

Position held:

Employment dates:

Salary (staring and ending):

Duties:

What did you like most and least about this job?

Reason for leaving:

May we contact this employer?
YesNo

Employer:

Address:

Phone number:

Supervisor’s name:

Position held:

Employment dates:

Salary (staring and ending):

Duties:

What did you like most and least about this job?

Reason for leaving:

May we contact this employer?
YesNo

Employer:

Address:

Phone number:

Supervisor’s name:

Position held:

Employment dates:

Salary (staring and ending):

Duties:

What did you like most and least about this job?

Reason for leaving:

May we contact this employer?
YesNo

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.

I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. I understand that any false information will result in a refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character, and qualifications.
YesNo

If hired I will be responsible for familiarizing myself with all rules and regulations of McIntosh Energy Co., Inc. as they presently exist or are later modified. If hired, I understand my employment can be terminated, at the discretion of the company or at my option, without notice, at any time, except as specifically set forth in writing in a current individual employment agreement, which I have entered into with the company.
YesNo

I also understand that no representative of the company has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the President.
YesNo

I understand that this application is not an offer of employment and no promises or representations of employment have been made to me at this time.
YesNo

By signing below, I authorize the company to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I further authorize the company to order one or more consumer reports containing financial, driving record, and/or other information about me from a consumer reporting agency. I understand that the consumer report(s) will be requested and used for the purpose of evaluating me for employment, promotions, transfers, and/or retention as an employee.

I have read, understand, and agree with the above.

(Sign with your mouse or touchscreen in the blank space below.)