Blue Hill Co-op Application

Name: *
Name:
Address: *
Address:
Primary Phone: *
Primary Phone:
Preferred Contact: *
Please be very specific and honest. Do not overestimate your true availability.
What date can you start? *
What date can you start?
Which days CAN you work? *
Are you willing to work 6-8 hours on either SAT or SUN? *
Are you willing to work both SAT and SUN? *
If hired, may we expect you to work here consistently for a year? *
Do you have any commitments to another employer that might affect your employment at the Co-op? *
Please provide complete and accurate information on your previous job duties and levels of responsibility. Start with your most recent experiences first. If you have a resume you may email it to info@bluehill.coop. If you do this, make sure the email contains your name and the fact that you are submitting your application online.
Former Employer One
Business phone:
Business phone:
Beginning date:
Beginning date:
End date:
End date:
May we contact this employer?
Former Employer Two
Business phone:
Business phone:
Beginning date:
Beginning date:
End date:
End date:
My we contact this employer?
Former Employer Three
Business phone:
Business phone:
Beginning date:
Beginning date:
End date:
End date:
May we contact this employer?
Please list information for three persons not related to you, who are familiar with your past work experience, and have known you for at least one year.
Reference One
Phone: *
Phone:
Reference Two
Phone: *
Phone:
Reference Three:
Phone: *
Phone:
Please state where and when you acquired skills and experience in the following areas:
Education
General Questions
Legal Stuff
If you have been convicted of a crime, please state the crimes and explain the date, location, nature, and facts surrounding each conviction. (An affirmative answer will not automatically disqualify you from being considered as a candidate for employment.)
The Blue Hill Co-op is an equal opportunity employer. Applicants are considered for positions for which they have applied without regard to race, color, ancestry, religion, sex, gender, national origin, sexual orientation, disability, and other characteristics protected by law.
Agreement (Please read carefully) *
I authorize my present and former employers (unless otherwise indicated on this application) to release to the Co-op any information concerning my employment, including my job performance. Furthermore, I release all these parties from any liability for any damage, (except that resulting from misrepresentation,) which might result from furnishing this information. The information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I understand that falsified information or significant omissions may disqualify me from further consideration and may be considered justification for dismissal if discovered at a later date. I understand that employment at the Co-op is for no definite period of time. The Co-op, as an At Will Employer, has at all times the right to terminate the employment relationship. I hereby acknowledge that I have read, understand, and agree to the proceeding statement:
Please type full name
Date: *
Date: