JOB APPLICATION FORM
MEISER'S FRESH GROCERY & DELI BY YOUR STORE OF THE QUEEN CITY ("MEISER'S")

1. Please read "NOTICE TO APPLICANT"
2. Complete all pages of this form.
3. If more space is needed to complete any question, please use "additional information" at the end of the form for comments.
4. Incomplete or indecipherable applications may not be processed.
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NOTICE TO APPLICANT
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract.  Please answer all questions completely and accurately. Incomplete, false, or misleading statements during the interview and on this form may result in rejection from the application process or, if discovered after employment, termination of employment.  All qualified applicants will receive consideration without discrimination because of sex, religion, veteran status, race, age (40 & over), creed, national origin, or the presence of legally protected disabilities.  Additional testing of job-related skills may be required prior to employment.  After an offer of employment, and prior to reporting to work, you may be required to complete required pre-employment screenings and/or random screenings; if applicable to the position and at discretion of the employer.
NAME (Last, First, Middle Initial)
PREFERRED NAME
SOCIAL SECURITY NUMBER
PREFERRED PHONE NUMBER
EMAIL ADDRESS
CURRENT HOME ADDRESS (Street address, City, State, Zip code)
For what position are you applying?
Please provide your information
Rate of pay expected
Please provide your information
If offered employment, on what date can you start?
MM
/
DD
/
YYYY
For which schedules are you available to work? (Please check all that apply)
Are you legally authorized to work in the U.S.? (If yes, additional proof is required.)
Clear selection
Have you ever been convicted of a felony or violent crime in the past 7 years?
Clear selection
If you answered "yes" please provide incident date, city/state and charge below.
Next
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