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Application for Employment

Chief Super Market, Inc. is an equal employment opportunity employer. It is our policy to administer all of our employment practices, including those pertaining to recruitment, hiring, placement, transfer, promotion or compensation, layoff or termination, and selection for training in a nondiscriminatory manner without regard to age, color, gender/sex, sexual orientation, gender identity, national origin, disability/handicap, genetic information, race, religion, creed, or military/veteran status or any other basis prohibited by federal, state, or local law. We endeavor to use the abilities of each Associate as fully as possible by taking into account experience, ability and personal interest. We also attempt to provide a working environment that is conducive to health, comfort, and efficiency.

Position Information
Location

Your Information
Your Address
General Questions
Education
School Name Location Years Attended Did You Graduate?
Elementary
High School
College
Other
Employment History
List all employers starting with present or most recent.
Please fill this section out completely, in addition to any resume you may be attaching.
Currently employed?
Currently on layoff subject to recall?
May we contact your present employer?
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Is this a complete list of your employment?
Have you ever been discharged from any position?
References
Name Relationship Phone Number
Availability
Please indicate AM or PM
MON TUE WED THU FRI SAT SUN
From
To
Type of Employment
Other Information
Summarize special skills and qualifications acquired from employment or other experience.
Why have you left or are planning to leave your present job?
Please indicate any further information you would like to add
If hired, do you have reliable means of transportation?
Read Carefully Before Signing
  1. I have read and do understand the statements contained herein and certify that they are true, complete and accurate. If I have left a response blank, I have done so intentionally.
  2. I understand that false or incomplete statements on this application, in any resume or supporting documents, in the interview process or after employment commences are grounds for rejecting the application and for dismissal at any time after the statements are discovered no matter when the discovery occurs.
  3. I declare that I am legally entitled to work in the United States of America and will, prior to commencing employment, provide verification on a Form I-9.
  4. I authorize the company or any of its subsidiaries, agents, or employees to contact all previous employers, personal references and educational institutions in connection with my application for employment. I understand that the company's pre-employment investigation may also include a check of my criminal record, if any, and of the circumstances surrounding any conviction. I understand that any information gathered as a result of this investigation will be used solely for purposes of determining my fitness for employment. I consent to the investigation to be conducted and to the release to the company of the information specifically described in any separate consents and authorizations I have signed, which shall become a part hereof. In consideration of the company's review of my application, I agree to release and hold harmless the company, its subsidiaries, agents, and employees, and all previous employers and educational institutions, from any claimed liability arising from this investigation.
  5. In the event that I am employed by the company, or any of its subsidiaries, I agree to comply with and be governed by all its policies and procedures in effect at a given time, and I acknowledge that none of its policies and procedures constitute terms of employment contrary to paragraph 6 below.
  6. I acknowledge that this application is for employment of an indefinite duration, terminable at will and for any reason, either by me or by the company or any of its subsidiaries, except as otherwise provided by the terms of a collective bargaining agreement, if any, applicable to me.
  7. I understand that the terms of paragraph 6 cannot be altered except by a written agreement executed by an officer of the company or the subsidiary which employs me.
  8. I understand that, if hired, I may be required to work weekends.
  9. In consideration of the company's review of my application, I agree that any claim or lawsuit arising out of my employment with, or any application for employment with the company or any of its subsidiaries must be filed no more than six months after the date of the employment action that is the subject to the claim or lawsuit. While I understand that the statute of limitations for claims arising out of an employment action may be longer than six months, I agree to be bound by the six month period of limitations set forth herein, and I WAIVE ANY STATUTE OF LIMITATIONS TO THE CONTRARY. Should a court determine in some future lawsuit that this provision allows an unreasonably short period of time to commence a lawsuit, the court shall enforce this provision as far as possible and shall declare the lawsuit barred unless it was brought within the minimum reasonable time within which the suit should have been commenced.
  10. This application form supersedes any other application forms that I have previously submitted to the company. This application will be maintained only for 60 days. Any interest in becoming employed thereafter will require a new application.
Chief Super Market, Inc. does not hire individuals who are current users of illegal substances. By signing this application, you affirm that you do not now, and will not for the duration of your employment with Chief Super Market, Inc., use illegal drugs.
By providing your name in the box below, you are signing this document and affirming that the information provided is correct.