Apps

15530 PURITAN
DETROIT, MI 48227

APPLICATION FOR EMPLOYMENT AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, sex, religion, national origin, age, marital or veteran status, the presence of non job-related medical conditions or disabilities or any other legally protected status. Name: Address: Home Phone: ( ) Cell Phone: ( ) City: Date State : Social Security Number: Zip:

Position for which you are applying: Lowest acceptable wage: Are you available to work: Full Time: Referred by: per Part Time: Date you can start: Temporary: Recruited: Days: Evenings: Walk-in: Weekends: All: __

Newspaper ad:

Other, Please list: No:

Are you either a U.S. citizen or legally eligible to hold employment in the United States? Yes: Are you at least 18 years old? Yes: No: If no, birthdate: Yes:

Are you related to anyone employed by GREENFIELD MARKET? No: If yes, name of the person, relationship and location employed: Have you ever worked for GREENFIELD MARKET? No:____________ Yes: If yes, give dates: Position: Supervisor's Name:

LIST HOURS AND DAYS NOT AVAILABLE TO WORK Sunday Monday Tuesday From (time) To (time)

Wednesday

Thursday

Friday

Saturday

EDUCATION Type of School High School College Tech, trade, grad or other

Name and Address of School

(including city, state, zip)

Diploma Degree Yes: No: Yes: No: Yes: No:

Major/Course of Study

List any additional special education, training, skills or machines operated: Do you have any disabilities that may limit your ability to perform the work for which you are applying? No: If yes, please explain: What can be done to accommodate your limitation? Have you ever been convicted (found guilty) of attempting or committing any crime other than a minor traffic violation? If yes, when? For what? Yes:

Note: A conviction record will not necessarily bar individuals from employment. You are not required to reveal records which have been judicially...