Ayer Shop 'n Save Employment Application

Please complete and submit this application to be considered for employment at Ayer Shop 'n Save.
We appreciate your interest in working with us!

Personal Information
Name *
Name
Address *
Address
Phone *
Phone
Referred by
Referred by
Employment Desired
Date You Can Start *
Date You Can Start
$
Are you employed now? *
If so, may we inquire of your present employer?
Are you legally authorized to work in the U.S.? *
Have you ever applied to this company before? *
Have you ever worked for this company before? *
Name of Last Supervisor at This Company
Name of Last Supervisor at This Company
How did you find out about this company? *
Please select all that apply.
Education History
Address
Address
Did you graduate?
Address
Address
Did you graduate?
General Information
Military Service Record
Have you ever served in the U.S. Armed Forces? *
Discharge Date
Discharge Date
Former Employers
Address
Address
Starting Date
Starting Date
Leaving Date
Leaving Date
$
$
May we contact your supervisor?
Name of Supervisor
Name of Supervisor
Phone
Phone
Address
Address
Starting Date
Starting Date
Leaving Date
Leaving Date
$
$
May we contact your supervisor?
Supervisor Name
Supervisor Name
Phone
Phone
References
1. Reference Name
1. Reference Name
Address
Address
Phone
Phone
2. Reference Name
2. Reference Name
Address
Address
Phone
Phone
3. Reference Name
3. Reference Name
Address
Address
Phone
Phone
Special Purpose Questions
Do not answer any of the questions in this box unless the employer has checked the box preceding a question, thereby indicating that the information is required for a bona fide occupational qualification, or dictated by national security laws or is needed for other legally permissible reasons.
Are you a U.S. citizen?
Have you been convicted of a felony or misdemeanor in the last 5 years?
You will not be denied employment because of a conviction record, unless the offense is related to the job for which you applied.
I understand that:
I may be required to take one or more: physical examination, drug test, or lie detector test, as a condition of hiring or continued employment. I agree to consent to take such test(s) at such time as designated by the company, and to release the company, its directors, officers, agents or employees from any claim arising with each of the tests.
I have been advised that:
lie detector tests, as a condition of hiring or continued employment, are prohibited by law.
Are you able to perform each of the following functions with or without an accommodation?
Job Function #1