Lowery's Meat & Grocery

Southwest Michigan's Premiere Meat Market

Application for Employment

What position are you interested in? *

First Name *
Last Name *

E-mail *
Phone *

Address *


Referred by?
Desired Wage? *

Are you 16 or older? *YESNO
Are you 18 or older? *YESNO

What date can you start? *

What days are you available for work?*
MONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAYSUNDAY

Do you have commitments to another employer that might affect your employment with us? If so, explain.

Have you ever been convicted of a crime, other than a traffic offense? If so, explain.*

Are there any positions or job duties which you cannot perform because of physical, mental, or medical handicap? If so, explain.

Educational History

Name of High School *
Average Grades *
Did you graduate?*YESNO

Name of College
Average Grades
Did you graduate?YESNO

Do you have any special training? If so, explain.

Former Employers

Former Employer(1)*

Name of Employer *
Name of Business *

Address of Business*


Dates worked?*
Wage *
Position *

Reason for leaving? *

Former Employer(2)

Name of Employer
Name of Business

Address of Business


Dates worked?
Wage
Position

Reason for leaving?

Former Employer(3)

Name of Employer
Name of Business

Address of Business


Dates worked?
Wage
Position

Reason for leaving?

References

Give the names of three persons that you are not related to and that you've known for at least one year.

Reference (1)*


Reference (2)*


Reference (3)*


Emergency Contact

In case of emergency please notify the following person:

Emergency Contact*

First Name *
Last Name *

Phone *

Address *


Please answer the question below. It is our SPAM filter. *