Tom's Food Markets

Management

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Locally Owned. Family Owned. Community Based.

Tom's Food Markets, Inc.

Personal Information Employment
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 felony crime, NOT INCLUDING 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?

I understand that to be employed I must be lawfully authorized to work in the United States, and I must show the employer documents that will prove this.

I understand that the company will thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me, and I release them from all liability for damage in providing this information. I authorize the company to secure records regarding my criminal conviction history from the appropriate law enforcement agencies.

All of the information on this application and made in conjunction with this application is correct and true to the best of my knowledge. I understand that any false or misleading statement made by me in connection with this application or the failure to disclose any material information will be grounds for immediate dismissal.

In consideration of my employment, I agree to conform to the rules and regulations of this company, an my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the company or myself. I understand that no manager or representative of this company, other than the president/owner of the company, has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.

The company complies with the ADA and state and local laws protecting qualified individuals with disabilities against discrimination in employment. We also provide reasonable accommodation for such individuals in accordance with these laws. If an employer believes that accommodation of a disability is necessary to perform the essential functions of a position, Michigan law requires the employee to notify the Company of this need in writing within 182 days after the employee knows or reasonably should have known of the need for accommodation. All requests for reasonable accommodation must be referred to the Market Director.

Applications become inactive after 90 days. If you wish to be considered after that time, you must complete a new application.