Weis Employment Application – Fill Out and Use This PDF

weis Application for Employment

Weis Markets is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of actual or perceived age, sex, sexual orientation, race, color, creed, religion, familial status, ethnicity, national origin, alienage or citizenship, disability, marital status, military or veteran status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. Applicants with a disability may be entitled to reasonable accomodation under terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accomodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Weis Markets. Please inform a Company representative if you need assistance completing any forms or to otherwise participate in the application process.

This application will remain active for 60 days, after 60 days, you must reapply for further consideration.

You should answer “no record” if a conviction has been sealed or expunged or otherwise statutorily eradicated. If you checked yes, please explain below. If more space is required, please use seperate sheet. A criminal conviction will not necessarily be a bar to employment. To help us evaluate your application, please describe the nature of the crime and your subsequent rehabilitation.

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EMPLOYMENT AVAILABILITY

Position(s) applied for_______________________________________________ Date you can start____________________________

month/day/year

Wages desired? $______________per hour, or $______________per week

We are a 7-day-a-week business with emphasis on nights and weekends. Please indicate your availability below:

Put the specific hours (From/To) you are available for work in the boxes below. (Leave the box empty if you are not available at all that day and write “A” under any day you are “available” all that day without any scheduling restrictions.)

From (AM/PM)

To (AM/PM)

Form #45 Revised 6-1-04

Other education, training, skills or hobbies relevant to employment consideration________________________________

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EMPLOYMENT HISTORY

*Beginning with the most recent employment, list the last four employers (including military service) or cover at least a seven year period, whichever is longer. Use seperate sheet if necessary.

*ALL employment information above must be completed in full for your application to be considered.

If yes, give employer name, date of action, and reason _________________________________________________________________

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If yes, and not included above, give dates employed, position, any other name used and reason for leaving________________________

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For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the

organizations you have listed? YES NO

If yes, specify name _________________________________________________________________________________________

REFERENCES

List two professional references familiar with your work ability (exclude relatives)

READ CAREFULLY AND SIGN

PLEASE READ THESE STATEMENTS OVER CAREFULLY AND INITIAL EACH PARAGRAPH BEFORE SIGNING AT THE BOTTOM

FOR MARYLAND APPLICANTS ONLY:

Maryland lie detector law - “Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a lie detector or similar test. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not exceeding $100.”

Note: An offer of employment is conditioned upon complying with Weis Markets’ requirements including, but not limited to signing a Consent to Conduct an Investigation.

MY SIGNATURE IS EVIDENCE THAT I HAVE READ AND AGREE WITH THE ABOVE STATEMENTS

Applicant’s signature __________________________________________________________________ Date____________________________