Employment Application

Applicant Information

Store(Required)

Name(Required)

First Last

Email(Required)

Phone(Required)

Position(s) Applying For(Required)

(be specific – max 3)

Date Available(Required)

Current Street Address(Required)

Current City(Required)

Current State and Zip Code(Required)

Mailing Address same as Current Address(Required)

Yes

Mailing Street Address(Required)

Mailing City(Required)

Mailing State and Zip Code(Required)

Provide any different names you have utilized since age 18

Which time periods are you available to work?(Required)

Full-Time, available Weekdays and Weekends

Part-Time, available Weekdays and any shift between 6:00am-12:00am on Weekends

Part-Time, ONLY Weekends

Other

Shift Availability(Required)

6:00am – 12:00am

8:00pm – 10:30am

Preferred Weekday Start Time(Required)

Explain Other Availability:(Required)

Do You Have a Reliable Source of Transportation To And From Work?(Required)

Yes

Do You Have A Valid Drivers License? (Applicable only for certain positions)(Required)

Yes

Are You At Least 18 Years Of Age?(Required)

Yes

Are You Legally Eligible To Work In The United States?(Required)

Yes

Are You Under 16 Years Of Age?(Required)

Yes

The essential function of most jobs at Woodman's will require that employees lift up to 50 lbs. frequently, bend and stoop frequently, push carts frequently, stand and/or walk for long periods of time, some climbing, and work in extreme temperatures. To the extent these function may be applicable to the position for which you are applying, can you perform all of the above functions with reasonable accomodation?(Required)

Yes

Answering “NO” to this inquiry is not an automatic bar to employment. Woodman’s is an equal opportunity employer and complies with all facets of the American with Disabilities Act (and any applicable state laws).

Do you have any pending criminal charges against you?(Required)

Yes

Have you ever been convicted of a crime, regardless of whether it was a felony or misdemeanor?(Required)

Yes

If you answered yes to either criminal background inquiries above, provide the date and county of the pending charge or conviction, the type of charge or conviction, and an explanation. (A pending charge or prior conviction will not automatically bar you from employment.)(Required)

Have you served in the military?(Required)

Yes

Where you honorably discharged?(Required)

Yes

Branch:(Required)

Years:(Required)

Rank At Discharge:(Required)

Education

Highest Grade of Year Completed In School(Required)

High School Diploma or GED?(Required)

Yes

High School Name:(Required)

Location:(Required)

Training Beyond High School (College, University or Other Schools)(Required)

Yes

School Name:(Required)

Location:(Required)

Major Field:(Required)

Years Attended:(Required)

Credits Earned:

GPA/Basis:

Degree Earned:(Required)

Describe any other education or training which you feel is relevant to the jobs(s) for which are you are applying. Also include relevant licenses and certifications. Be Specific.

Work Experience

Provide a description of all jobs. Be specific. Start with you most recent job. For part-time work, show the average number of hours worked per week. Indicate any change in job title with the same employer as a separate job.

Number of Previous Jobs(Required)

None

One

Two

Three

Job 1

Employer:

Type of Business:

Street:

City:

State and Zip Code

Job Title:

Reason For Leaving:

Employment Status

Name of Supervisor:

Job Duties:

From (Month & Year):

To (Month & Year):

Starting Salary

Ending Salary

Job 2

Employer:

Type of Business:

Street:

City:

State and Zip Code

Job Title:

Reason For Leaving:

Employment Status

Name of Supervisor:

Job Duties:

From (Month & Year):

To (Month & Year):

Starting Salary

Ending Salary

Job 3

Employer:

Type of Business:

Street:

City:

State and Zip Code

Job Title:

Reason For Leaving:

Employment Status

Name of Supervisor:

Job Duties:

From (Month & Year):

To (Month & Year):

Starting Salary

Ending Salary

May we communicate with your present employer?(Required)

Yes

May we communicate with your former employer?(Required)

Yes

Have you done any volunteer work?(Required)

Yes

Please describe your volunteer work:(Required)

Have you worked for Woodman's before?(Required)

Yes

Which store?(Required)

What years?(Required)

References

List up to three references other than former employers or relatives.

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Disclaimer and Signature

BY MY SIGNATURE BELOW, I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACTS ON THIS APPLICATIONS (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of Woodman’s to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, sexual orientation, or pregnancy, and to afford equal opportunities to disabled veterans, individuals with a disability, and any other characteristics protected by federal, state or local laws. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release Woodman’s from all liability that might result from making an investigation. I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.

Disclaimer Agreement(Required)

I Agree to the Disclaimer Above

Applicant Signature(Required)

(Type Name)

Signature Date(Required)

How did you hear about our job opening?

Social Media

In-Store sign

In-Store Announcement

Job Fair

Semi Trailer

Employee Referral

Employment Website

Other

Employee Name

Site Name

Please Describe "Other"

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