Mariana's

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If you are interested in a position at a Marianas store, please fill out the following mini application. You may also print a copy and bring it to the Human Resource Manager at your local Marianas store.

All fields with * must be filled out.

First Name *
Last Name *
Address*
City*
State*
Zip*
Phone*
Aternative Phone*
Email*

Are you either a U.S. citizen or authorized to work in the United States?

Desired position *

Bakery	Grocery	Meat
Cashier	Human	Produce
Deli	Maintenance	Waitress
Driver	Management	Warehouse

Are you interested in *

F/T

P/T

Either

Are you 18 or older *

Yes

Date Available

Salary Desired

Are you currently working?

Can we contact your previous employer? *

Have you previously been employed with Marianas? *

If so, where?

Do you have any family members working at Marianas?*

If so, where?

Please specify the hours you are able to work *

Sunday	Monday	Tuesday	Wednesday

Thursday	Friday	Saturday

Were you previously employed by Marianas Market? *

Yes

EDUCATION *	SCHOOL NAME	YEAR	GRADUATION DATE	SUBJECT STUDIED
HIGH SCHOOL
COLLEGE
CERITFICATIONS
OTHER COURSES

GENERAL

WHAT LOCATION WOULD YOU LIKE TO WORK AT? *

DO YOU HAVE A HEALTH CARD?

Yes

DO YOU HAVE A TAM CARD?

Yes

DO YOU HAVE A SHERIFFS CARD?

Yes

MILITARY?

RANK

ACTIVE MEMBER?

PREVIOUS EMPLOYMENT *(Please place an N/A,if no information is entered here)

DATE		COMPANY NAME	SALARY	POSITION	REASON FOR LEAVE
FROM	TO
FROM	TO
FROM	TO
FROM	TO

REFERENCES:

	NAME	PHONE NUMBER	ADDRESS	YEARS KNOWN
1
2
3
4

EMERGENCY CONTACT INFORMATION:

NAME

ADDRESS

PHONE NUMBER

- -

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CERTIFICO QUE LOS DATOS ESCRIOS EN ESTA SOLICTUD SON VERIDICOS Y COMPLETOS COMO LA MEJOR REFERENCIA DE MI PORSONA Y ENTIENDO QUA SI SOY CONTRATADO. LA FALSIFICATION DE DATOS DE ESTA APLICACION SERA SUFICIENTE PARA SER DESPEDIDO. AUTORIZO LA INVESTIIGACION DE TODOS LOS DATOS LLENADOS AQUI, DE LAS REFERENCIAS LISTDAS ARRIBA Y DE TODA LA INFORMATION SOBRE MIS EMPLEOS ANTERIORES PARA VERIFICAR CUALQUIER DATO PERTINENTE QUE PUEDA SERUTIL SOBRE DANOS Y PERJUICIOS QUE PUDIESEN RESULTAR TAMBIEN A LA COMPANIA. ACEPTO Y ESTOY DE ACUERDO QUE EN CASO DE SER CONTRATADO, MI EMPLEO NO TENDRA UN PERIODO DEFINIDO Y QUA SIN IMPORTAR LA FECHA DE MI PAGO O SALARIO. ESTE PUEDE CONTRATADO, MI EMPLEO NO TENDRA UN PERIODO DEFINIDO Y QUE SIN IMPORTAR LA FECHA DE MI PAGO O SALARIO. ESTE PUEDE CONTRATADO, MI EMPLEO NO TENDRA UN PERIODO DEFINIDO Y QUE SIN IMPORTAR LA FECHA DE MI PAGO O SALARIO. ESTE PUEDE TERMINITION EN CUALQUIER MOMENTO.

Additional Comments

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