Employment Employment Application It is the policy of P&C Fresh to provide equal employment opportunities to all applicants and employees without regard to race, color, citizenship status, religion, sex, sexual orientation, marital status, age, national origin, status as an individual with a disability, or any other legally protected status as a disabled and/or Vietnam Era Veteran and to affirmatively seek to advance the principles of equal employment opportunity.Name* First Last Which P&C Location Are You Applying To?*P&C Fresh – CortlandP&C Fresh – IthacaAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Telephone*Cellular PhoneEmail* Are you at least 18 Years of Age? Yes No If not, are you at least 16 years of age? Yes No If under age 18, can you supply working papers? Yes No Are you legally eligible for employment in this country? Yes No Have you ever been employed by P&C Fresh? Yes No Which Location?When did you leave? MM slash DD slash YYYY Supervisor's Name?Why did you leave? Please be specific.Are you currently employed? Yes No Have you ever been discharged from any employment or asked to resign? Yes No If yes, please explain.A Summary of skills that may be applicable to Retail EmploymentPrevious EmployerPositionPrevious Employer – Start Date MM slash DD slash YYYY Previous Employer – End Date MM slash DD slash YYYY Previous EmployerPositionPrevious Employer – Start Date MM slash DD slash YYYY Previous Employer – End Date MM slash DD slash YYYY Best Way to Contact YouHome PhoneMobile PhoneEmailBest time to contact you? : Hours Minutes AM PM AM/PM Do you have any relatives employed by P&C Fresh? Yes No If Yes, name of relative? Location?Daily AvailabilityEx: If you are able to work from 9am-5pm please put “9am-5pm”MondayTuesdayWednesdayThursdayFridaySaturdaySundayHave you even been convicted of a felony? Yes No If yes, please explain.Have you been convicted of a criminal offense in the last five (5) years? Yes No If yes, please explain.Have you been convicted of a criminal offense for which your period of incarceration ended within the past five (5) years? Yes No If yes, please explain.Please Confirm* Falsification of any portion of this application will result in disqualification and/or termination if hired.CAPTCHA
