Tom's Food Markets, Inc.

Personal Information
Name:
Home phone number:
Alternate phone number:
Email:
Address line 1:
Address line 2:
City:
State:
Zip:
Are you 16 or older?:
Are you 18 or older?:
List outside interests:

Please don't list any activities which would reflect race, color, religion, sex, national origin, disability or ancestry.


General Information
Have you ever worked for Tom's?
If yes, give the start
and end dates of employment:
Are any of your relatives employed by this company?
If yes, please list name(s), relationship and store location:
Have you ever been convicted of a crime, excluding misdemeanors and traffic violations?
If yes, describe in full:

(The existence of a criminal record will not automatically disqualify you from the job you applied for.)


Work History 1 (Present or Most Recent Employer)
Have you ever been disciplined for absenteeism or tardiness (at any job)?
May we contact your current employer?
Company name:
Address:
Phone number:
Supervisor:
Start date:
End date:
Rate of pay:
Position held:
Major responsibilities:
Reason for leaving:

Work History 2 (Next Most Recent Employer)
Company name:
Address:
Phone number:
Supervisor:
Start date:
End date:
Rate of pay:
Position held:
Major responsibilities:
Reason for leaving:

Work History 3 (Next Most Recent Employer)
Company name:
Address:
Phone number:
Supervisor:
Start date:
End date:
Rate of pay:
Position held:
Major responsibilities:
Reason for leaving:

US Military History
Branch of service:
Served from date:
Served to date:
Describe any special training:

Educational History
What is the last grade completed in high school:
Average grades:
Name Of school:
Location of school:
What is the last year completed of college, tech, or business school:
Average grades:
Name of school:
Location of School:
What scholastic honors did you receive?
What activities and organizations did you participate in?

Please don't list any activities which would reflect race, color, religion, sex, national origin, disability or ancestry.


Work Availability
Position applying for:
Preferred Market:
Date available to start:
Wage expected (per hour):
Type of employment that is desired:
Number of hours available per week:

To help us consider a job that matches your availability, please specify the days and time each day you are available to work (e.g. 8am-5pm, 5pm-10pm, any or none). Each market is open daily from 7am-10pm:

Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Do you have commitments to another employer that might affect your employment with us?
Are you legally eligible for employment in the United States?





Locally Owned. Family Owned. Community Based.