Application for Employment

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WWCP is an Equal Opportunity Employer

PERSONAL INFORMATION

Date: *

YYYY

Name: *

Address: *

E-mail Address: *

Home Phone: *

Mobile Phone: *

Are you eligible to work in the U.S.? *

Are you at least 18 years or older? *

(If no, you may be required to provide authorization to work.)

Can you work overtime, including weekends? *

EMPLOYMENT DESIRED

Position: *

Date Available: *

YYYY

Are you currently employed? *

If so, please provide your employer's name and contact information:

May we contact your present employer?

REFERRAL SOURCE

How did you hear about WWCP/this position? *

Have you ever worked for WWCP or Weavers Way Co-op? *

If so, in what capacity?

Do you know anyone who works for WWCP? *

If yes, whom?

EDUCATION

HIGH SCHOOL

Name:

City and State:

Date of Graduation:

COLLEGE / UNIVERSITY

Name:

City and State:

Dates Attended:

Major:

Degree:

PROFESSIONAL, GRADUATE, CONTINUING EDUCATION

Institution Name:

City and State:

Dates Attended:

Specialization:

Degree or Certificate:

EMPLOYMENT HISTORY

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

For each position, please provide the following information:

Name of Employer
Dates of Employment
Job Title
Name of Immediate Supervisor and Title
Address and Telephone Number of Employer
Nature of Work and Job Responsibilies
Hourly Rate/Salary

Employment History: *

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for? *

If yes, please explain:

Do you have any computer skills that would enhance your ability to perform the position applied for? *

If yes, please list:

References

Please provide the names and contact information of three (3) people not related to you, whom you have known for at least three (3) years and who can be contacted as references.

Reference Name 1:

Telephone Number 1:

Reference Email 1:

Relationship 1:

Reference Name 2:

Telephone Number 2:

Reference Email 2:

Relationship 2:

Reference Name 3:

Telephone Number 3:

Reference Email 3:

Relationship 3:

Please read carefully before signing.

WWCP is an equal opportunity employer. WWCP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

WWCP expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of WWCP’s employees to perform their job duties may result in discipline up to and including discharge.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for WWCP to hire me. If I am hired, I understand that either WWCP or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of WWCP has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to WWCP true and complete information on this application. No requested information has been concealed. I authorize WWCP to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Signature: *

By typing my name below, I am electronically signing my application.

Date: *

YYYY

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