Application – Blue Hill Co-op

First Name *

Last Name *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Email *

Confirm Email

Beginning Date

End Date

May we contact this employer?

Reason for Leaving

Former Employer Two

Name of Employer

Type of Business

Your Job Title

Duties

Business Phone

Business Address

Name of Supervisor

Beginning Date

End Date

May we contact this employer?

Reason for Leaving

Former Employer Three

Name of Employer

Type of Business

Your Job Title

Duties

Business Phone

Business Address

Name of Supervisor

Beginning Date

End Date

May we contact this employer?

Reason for Leaving

References

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

Name *

Phone *

Relationship *

Reference Two

Name *

Phone *

Relationship *

Reference Three

Name *

Phone *

Relationship *

Education

Name of High School

When did you graduate?

If you didn't graduate, do you have a G.E.D.?

Name of College or University

Dates Attended

Major

Degree

Other Training

Legal Stuff

Are you legally authorized to work in the U.S.? *

Are you 18 years or older? *

Have you worked for the Blue Hill Co-op before? *

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: *

I have read and agree
I do not agree

Signature *

Date *

Captcha *

70 South Street, Blue Hill, Maine

Your Community-Owned Grocery Store

Job Application

Availability

Work History

Former Employer One

Former Employer Two

Former Employer Three

References

Reference One

Reference Two

Reference Three

Education

Legal Stuff

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)

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