Conner’s Supermarket

At Conner’s Supermarket we strive to hire the best help available.  We have excellent benefits including a comprehensive Blue Cross Blue Shield plan, Retirement plan, flexible hours, and  happily employ workers year round.  Please fill out an application and give it to Angie or Becky, if they are unavailable please leave the application with the cashiers. Thanks for your interest
Text Box: CONNER'S SUPERMARKET EMPLOYMENT APPLICATION WE ARE AN EQUAL OPPORTUNITY EMPLOYER (PLEASE PRINT ALL RESPONSES) DATE:__________________SOCIAL SECURITY #__________________________ NAME:______________________________________________________________ ADDRESS:___________________________________________________________ PHONE:_____________________________________________________________ TYPE OF POSITION DESIRED:_________________________________________ FULL TIME, PART TIME, OR TEMPORARY:______________________________ PLEASE INSERT TIMES ON EACH DAY YOU WOULD BE AVAILABLE FOR WORK. MON._____ TUES._____ WED._____ THURS._____ FRI._____ SAT. _____ SUN._____ HOW SOON WOULD YOU BE AVAILABLE FOR WORK:_____________________ SALARY REQUIRED:____________________ ARE YOU 16 OR OLDER:____________ ARE YOU 18 OR OLDER:____________ PRIMARY LANGUAGE – ENGLISH _____ OTHER________________________ ARE YOU ABLE TO LIFT 25LBS:______ 50LBS:______ HAVE YOU EVER BEEN CONVICTED OF A CRIME? YES____ NO____ IF YES, GIVE FULL PARTICULARS:_____________________________________ FOR EACH TYPE OF SCHOOL YOU HAVE ATTENDED, PLEASE LIST THE SCHOOLS NAME, THE LAST YEAR YOU COMPLETED, AND INDICATE IF YOU GRADUATED GRADE SCHOOL:_____________________________________________________ HIGH SCHOOL:_______________________________________________________ COLLEGE:___________________________________________________________ BUSINESS OR TRADE SCHOOL:________________________________________ SPECIAL TRAINING:__________________________________________________ WHAT TYPES OF BUSINESS MACHINES DO YOU OPERATE?______________ HAVE YOU EVER BEEN DISCHARGED FROM ANY POSITION? YES____ NO____ IF YES, EXPLAIN:_____________________________________________________ EMPLOYMENT EXPERIENCE / WORK HISTORY START WITH YOUR PRESENT OR YOUR LAST EMPLOYER. IF YOU NEED MORE SPACE, USE AN EXTRA SHEET OF PAPER. IF SUMMER OR PART TIME WORK, PLEASE INDICATE. NAME OF EMPLOYER:________________________________________________ TYPE OF BUSINESS:__________________________________________________ CITY & STATE:______________________ PHONE:_________________________ SUPERVISOR/TITLE:_________________________________________________ STARTING DATE:________________ LEAVING DATE:_____________________ STARTING PAY:_________________ LEAVING PAY:_______________________ YOUR TITLES AND DUTIES:___________________________________________ _____________________________________________________________________ REASON FOR LEAVING:_______________________________________________ NAME OF EMPLOYER:________________________________________________ TYPE OF BUSINESS:__________________________________________________ CITY & STATE:______________________ PHONE:_________________________ SUPERVISOR/TITLE:__________________________________________________ STARTING DATE:________________ LEAVING DATE:______________________ STARTING PAY:_________________ LEAVING PAY:________________________ YOUR TITLES AND DUTIES:___________________________________________ _____________________________________________________________________ REASON FOR LEAVING:_______________________________________________ NAME OF EMPLOYER:_________________________________________________ TYPE OF BUSINESS:___________________________________________________ CITY & STATE:______________________ PHONE:__________________________ SUPERVISOR/TITLE:___________________________________________________ STARTING DATE:________________ LEAVING DATE:______________________ STARTING PAY:_________________ LEAVING PAY:________________________ YOUR TITLES AND DUTIES: ___________________________________________ ______________________________________________________________________ REASON FOR LEAVING ________________________________________________ ARE WE GRANTED PERMISSION TO CHECK ALL INFORMATION? YES____ NO____ EMPLOYERS WHOM YOU DO NOT WISH US TO CONTACT?______________________________________________________ I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION` IS CORRECT TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT DELIBERATE FALSIFICATION OF THIS INFORMATION IS GROUNDS FOR DISMISSAL IN ACCORDANCE WITH THIS COMPANY'S POLICY. SIGNATURE OF APPLICANT:_____________________________DATE:______________

Conner’s Supermarket

PO Box 71

47468 Highway 12

Buxton, NC 27920-0071

Phone:    (252) 995-5711

Fax:         (252) 995-5779

E-mail: conners5@embarqmail.com