Employment
 
 
Placement Information
 
DATE: 9/27/2021
*Position(s) applying for:
 
*Do you desire:
*Date you can start:
 
General Information
 
How did you hear about this job opening?
*Last Name:
 
*First Name:
 
*Middle Initial:
 
*Address:
 
*City:
 
*State:
 
*Zip Code:
 
*Primary Phone Number:
 
Message Phone Number:
Email Address:
*Have you applied here before?
 
*Have you been employed here before?
 
Have any relatives been employed at the Good Food Store?
*Have you ever been convicted, pled guilty or no contest, or forfeited bond or bail for any crime other than minor traffic violations?
Please note: Conviction does not automatically exclude you from consideration for employment.
 
 
Shift Availability
 
Please detail the times you are available to work each day, most schedules include weekend shifts.
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
 
Education History
 
Type of School
Name & Location
Major Subject
Years of Schooling
Degree - Credit
Did you Graduate?
High School:
Yes
College:
Yes
Graduate School:
Yes
Other:
Yes
 
Employment History
 
List your four most recent employers, starting with your present or last employer. List any periods of unemployment under “Name of Business”. Please include any periods of military service. If you have had a name change throughout your employment history, please state what and when in order to facilitate reference checks:
*May we contact your current employer?
 
*Name of Business:
 
Job Title:
*Address:
 
*City:
 
*State:
 
*Zip Code:
 
Office Phone:
Name & Title of Supervisor:
Reason For Leaving:
Date Started:
Date separated:
Starting Salary:
Ending Salary:
Description of Duties:
EQUAL OPPORTUNITY IN EMPLOYMENT
The Good Food Store is an equal opportunity employer, dedicated to a policy of non-discrimination in employment: on any basis including race, color, age, sex, religion, national origin or disability. Applicants may request: any needed accommodation to participate in the application process.
CERTIFICATION
I authorize the investigation of all statements contained in this application and any attachments or supporting documents, and in any interviews. I release from all liability any persons supplying the information. I also release the Good Food Store from all liability, which might result from making the investigation. I understand that part of the application process may include a criminal background check. I certify that the facts and information given are (or will be) true and complete to the best of my knowledge. I understand that omission or misrepresentation of facts called for is cause for dismissal, regardless of when and how discovered. I understand that there will be a probationary period at the beginning of my employment, and I may be discharged with or without cause at any time during my probationary period. I understand that I will be required to submit proof of my right to work in the United States if hired.
*Applicant Signature
 
 
Supplemental Questionnaire
 
1. *Explain why you are interested in applying for employment with the Good Food Store and why you are interested in the position(s) you are applying for?
 
2. *Please describe any skills, experience or types of equipment that you have worked with that prepare you for the position(s) you are currently applying for:
 

1600 S. 3rd St. West | Missoula, MT 59801 | 406.541.3663 | 7am to 10pm
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