Jumbo Foods - Enid, Oklahoma

Employment Opportunities

APPLICATION FOR EMPLOYMENT
Equal Opportunity Employer
This application of emloyment is not intended to be a contract of employment.

Please Note: Fields in BOLD are required.

Date

Name: First Middle Inital Last

Present Address: City State Zip Code

Phone Number Email Address

Are you at least 16 years old? Yes No

Position(s) Applied For:

Rate of Pay Expected:

Would you work: Full Time: Yes No – or – Part Time: Yes No

Specify days and hours not able to work:

Were you previously employed by us: Yes – No

If Yes, when and where

List any friends or relatives working for us:
Name Relation
Name Relation

Summerize special skills & qualifications acquired from employment or other expericence:

Education

School	Name & Location	Highest Grade Completed	List Degree or Diploma	Major
Secondary
College
Other

Employment History

1.	Company Name	2.	Company Name
	Address		Address
	Phone		Phone
	Employed From To		Employed From To
	Rate of Pay Start Last		Rate of Pay Start Last
	Name of Supervisor		Name of Supervisor
	Type of Business		Type of Business
	Your Title		Your Title
	Describe Major Functions of Your Job		Describe Major Functions of Your Job
	Reason for Leaving		Reason for Leaving
3.	Company Name	4.	Company Name
	Address		Address
	Phone		Phone
	Employed From To		Employed From To
	Rate of Pay Start Last		Rate of Pay Start Last
	Name of Supervisor		Name of Supervisor
	Type of Business		Type of Business
	Your Title		Your Title
	Describe Major Functions of Your Job		Describe Major Functions of Your Job
	Reason for Leaving		Reason for Leaving

Have you ever been convicted of a felony? Yes – No

If Yes, please explain:

May we contact the employers listed above? Yes – No

If not, indicated by number which one(s) you do not wish us to contact: 1. 2. 3. 4.

Would you agree to a physical examiniation paid for by the company if requested? Yes – No

The facts set forth above in my application for employment are true and complete. I understand that, if employed, false statements on this application shall be considered sufficient cause for dismissal.

THIS APPLICATION OF EMPLOYMENT IS NOT INTENDED TO BE A CONTRACT OF EMPLOYMENT.

For Office Use Only

Interview ______________________ Date ____/____/____

Signature of Applicant ____________________________________ Date ____/____/____

Department _________________________________ Date Started ____/____/____

Starting Pay Rate _________________

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