Lemon Tree Grocer

First Name:*

Middle Name:

Last Name:*

Address Line 1:

Address Line 2:

State:

City:

Zip:*

Phone:*

E-mail:*

Format : 8881234567

Are you eligible to work in the United States? *YesNo*

If you are under age 18, do you have an enployment/age certificate? Yes No

Have you been convicted of a felony with in the last five years? Yes No

If yes, please explain:

Position/Availability

Position Applied For:

Days/Hours Avilable:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Hours Available from:

From:

to:

What date are you available to start work?(mm/dd/yyyy):

Education

Name of the School :

Address of the School:

Degree/Diploma:

Graduation Date:

Skills and Qualifications: Licences, Skills, Training, Awards

Employment History:

Present Or Last Position:

Employer:

Address:

Supervisor:

Email:

Phone:

From:

To:

Responsibilities:

Salary:$

Reason for leaving:

May We Contact Your Present Employer:

Yes No

Reference:

Name/Title:

Address:

Phone:

Attach Resume:

*I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.*

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