| |
|
| First
Name: |
|
| Last
Name: |
|
| Address
1: |
|
| Address
2: |
|
| City: |
|
| State/Province: |
|
| Zip
Code: |
|
| Telephone: |
|
If
you are under 18 ,
can you furnish a work permit?
|
Yes
No |
Have
you ever been employed here before?
|
Yes
No |
| Date
Available: |
|
|
Type of employment desired: |
|
| Position
you are applying for: |
|
Are you able to meet the
attendance requirement of the job? |
Yes
No |
Have you ever been convicted of a felony in the last seven
years? |
Yes
No |
| If
Yes please explain why: |
|
Skills
Summarize
special skills and
qualifications acquired from employment
or other experiences that may
qualify you for work with our company: |
|
Educational
Background
High school: |
|
| Years
completed: |
|
| Did
you graduate? |
Yes
No |
| Course
of study: |
|
| College: |
|
| Years
completed: |
|
| What
was your major: |
|
| What
is your Degree: |
|
| Course
of study: |
|
| Trade
School: |
|
| Years
completed: |
|
| Did
you graduate? |
Yes
No |
| Course
of study: |
|
|
References |
|
Reference
#1:
|
|
| Reference
#1 telephone: |
|
How
many years have
you known Reference #1: |
|
| Reference
#2: |
|
| Reference
#2 telephone: |
|
How
many years have
you known Reference #2: |
|
| Reference
#3: |
|
| Reference
#3 telephone: |
|
How
many years have
you known Reference #3: |
|
| |
|
Employment
History |
List your last (3) employers, assignment
or
voluntary activities (at least 5 years),
starting with the most recent,
including military experience.
|
| Employer
#1: |
|
| Address: |
|
| Telephone: |
|
From
what date to what
date did you work? |
From:
To:
|
| What
was your job title? |
|
Who
was your supervisor and
what was their title? |
|
What
was the nature of your job
and/or list your responsibilities. |
|
| How
much where you making at start? |
$
per
|
| How
much where you making at finish? |
$
per
|
| What
was your reason for leaving? |
|
Employer
#2:
Please
include the following information -
Employer , Address, Telephone, dates
you worked, your pay rate,
and reason for leaving. |
|
Employer
#3:
Please
include the following information -
Employer , Address, Telephone,
dates
you worked, your pay rate,
and reason for leaving. |
|
| |
|
|
David's Supermarkets, Inc. (the "Company")
has adopted a Mandatory Arbitration Plan ("Plan")
for the benefit of the Company and its
employees. The purpose of the Plan is to
fairly and efficiently resolve disputes or
problems which may arise between the Company
and its employees. The Plan is the required
and exclusive way to deal with all disputes
between the Company and its employees. Neither
the Company nor the employees can sue in any
court based on any claim or dispute arising
out of or related to their employment.
Employees do not
give up any substantive right. The Company and
the employees simply agree to resolve their
disputes without resorting to suing one
another in a court of law. Both parties retain
their right to any recovery available under
law.
This is only a summary of the Mandatory Arbitration Plan. The Mandatory Arbitration Plan
is controlling over this summary and should be
read carefully by each applicant. A copy of the
Plan is available for review at each Company
location.
The Company values and respects each of its
employees and hopes that there will never be
any significant disputes with its employees.
However, if there is a dispute, the Company
wants its employees to know that the
employee's claims or disputes will be taken
seriously by the Company and the Company will
resolve the dispute in accordance with the
Mandatory Arbitration Plan.
This Plan is not and will not be construed to
create any contract of employment, expressed
or implied. Nor does this Plan in any way
alter the at-will status of any employment.
This Plan is a condition of hire and
employment.
NOTICE OF EMPLOYMENT APPLICATION
BY COMPLETING AND SUBMITTING THIS APPLICATION
FOR EMPLOYMENT WITH DAVID’S SUPERMARKETS,
INC., ("THE COMPANY"), I UNDERSTAND AND AGREE
THAT:
The Company has a Mandatory Arbitration Plan,
which is the required and exclusive way for
applicants, Employees and the Company to
resolve any and all disputes. I agree to
resolve any dispute between the Company and me
arising out of this application or, if the
Company hires me, out of my employment through
the Mandatory Arbitration Plan. |
|