APPLICATION FOR EMPLOYMENT
Times Super Market is an Equal Opportunity Employment Employer. We do not discriminate against any applicant and we comply with all applicable federal and state employment laws. Provide only the information requested on this application form and complete this entire application form. Failure to do so may result in the disqualification of your application.
I am applying at Times because:  
  
 
GENERAL INFORMATION:
             Last Name:
Name     		 First Name:
 MI
 Social Security Number:
Address:

Email: 		City:
 State:
 Zip:
 Telephone Number
Home:
Cell:   
Work:
Referred By:
 Best time to call:
EMPLOYMENT INFORMATION:
Date you can start work:
 Positions Applying For:
 Rate Desired:
Are you currently employed by Times??
  If "Yes"
Store:
Job:    		Have you ever applied at Times before?
   
If Yes When? 
Have you ever been employed by Times?
 
If "Yes" When?
AVAILABILITY:
Days: Wesnesday Thursday Friday Saturday Sunday Monday Tuesday
Earliest Starting Time:
Latest End Time:
 
Which areas of OAHU are you willing to work?
Experience, skills, or qualifications applicable to the position(s) you are applying for:
EMPLOYMENT RECORD: Starting with  your present or most recent, list all previous employers. Include self-employment, military service, summer, and part-time jobs. Please attach additional sheets, if necessary, following the same format.
Company Name:
 Phone:
Address:
 City:
 State:
 Zip:
Supervisor's Name:
Dates
Employed:
From:

To:
 Position
& Duties:
 Salary:

Starting:

Ending:
 Reason for Leaving
Company Name:
 Phone:
Address:
 City:
 State:
 Zip:
Supervisor's Name:
Dates
Employed:
From:

To:
 Position
& Duties:
 Salary:

Starting:

Ending:
 Reason for Leaving
Company Name:
 Phone:
Address:
 City:
 State:
 Zip:
Supervisor's Name:
Dates
Employed:
From:

To:
 Position
& Duties:
 Salary:

Starting:

Ending:
 Reason for Leaving
Company Name:
 Phone:
Address:
 City:
 State:
 Zip:
Supervisor's Name:
Dates
Employed:
From:

To:
 Position
& Duties:
 Salary:

Starting:

Ending:
 Reason for Leaving
EDUCATION:
Name of School Address Years Attended Degree/Diploma
Jr. High/Intermediate
High School
College
Other (Trade School, etc)
OTHER:
Do you know anyone working for the Company?   
If "YES", who?


Why would you like to work at Times?


If you are hired by Times, describe what you feel you can contribute to our Company or Store:
MEDICAL AND CRIMINAL CONVICTION INFORMATION:
>> After an offer of employment is made, applicants may be required to undergo a physical and/or other medical examination at Company expense and by a Company-chosen physician. Passing said examinations are a condition of employment.
I authorize the physicians conducting the examinations and any laboratory testing any specimen obtained by the physicians to disclose the results of the examinations and the laboratory tests to the Company.
>> The Company may inquire into and consider any criminal conviction record that you may have after it makes a conditional offer of employment to you. The Company may withdraw a conditional employment offer if you have a criminal conviction record which bears a rational relationship to the duties and responsibilities of the position for which you are applying. Any criminal conviction record that is more than 10 years old or that involves certain Family Court matters will not be considered.
>> Do you have a current Tuberculosis Clearance Card?   Date last tested:
IMPORTANT NOTICE:
It is the policy of the Company to hire only U.S. citizens and aliens who are authorized to work in the U.S. As a condition of employment, you will be required to produce original documents establishing your identity and authorization to work and to complete the U.S. Immigration and Naturalization Service's Form I-9.
CERTIFICATION:
I certify that all statements made on this application are true and complete to the best of my knowledge. I understand that my application will not be considered if it is incomplete. Further, I understand that any misrepresentation or omission will subject me to not being considered for hire or, if said misrepresentation or omission is discovered after hire then it may result in immediate termination of employment. I, hereby, authorize any investigation of the above or related work experience, education, or reputation information for purposes of consideration of my application for employment.

Notice to previous employers: I also authorize my previous employers to release any and all pertinent employment data to Times Super Market. This data will be used solely by Times Super Market in its hiring process.

This application is not a contract and connot create a contract. I understand that if I am employed by Times, my employment is "at will" and can be terminated at any time, either by myself or the Company, with or without cause or reason and with or without notice.



Application Date		  

Applicant's Signature (enter name)

Thank you very much for considering Times for your next job!!!