Name of current or most recent employer
Supervisor Phone Number
(555)-555-5555
May we contact this employer for a reference?
Supervisor Phone Number
(555)-555-5555
May we contact this employer for a reference?
Supervisor Phone Number
(555)-555-5555
May we contact this employer for a reference?
Please explain any gaps of 3 months or more in employment.
List any Co-op background, interests, extracurricular activities, sports, special
skills such as equipment operations, languages spoken/written, computer skills,
academic honors, scholarships, etc. (You may decline to list any organizations that
would depict your race, religion, ancestry, or disabilities.)
I hereby consent to the collection of the information in this application and to
its use for the purposes of assessing my suitability for employment with Peninsula
Co-op and, if I am hired, for employment administration purposes.
I consent to an investigation of work and personal references as necessary to determine
my suitability for employment.
I understand that upon being offered a position a criminal record and bonding check
may be required and that I must maintain a clear criminal record throughout my employment
with Peninsula Co-op. I further understand that certain positions may require a
credit check.
I hereby authorize my current employer (if applicable) and all previous employers
and organizations contacted by Peninsula Co-op to provide any relevant information
regarding my current and/or previous employment and I release all persons, employers
of any and all claims for providing such information.
I certify that the information given by me in this application is true and complete
to the best of my knowledge. I understand and agree that if I am hired, if any information
on this application is found to be false, such information may be cause for immediate
dismissal.