Lowery's Meat & Seafood

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. *