Employment Application – Cortez Fish Market

Employer Information

Employer: Cortez Bait & Seafood Fish Market
Address: 12110 Cortez Rd.
City/State/ZIP: Cortez, Florida 34215
Telephone: 941-794-1547

It is the policy of Cortez Bait & Seafood Fish Market to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.

Applicant Information

Name

First

Last

Address

Address Line 1

City

State

Zip Code

Numer of years at this address:

Daytime Phone

Email

Evening Phone

Driver's License (State/Number):

Mobile Phone

Emergency Contact

Who should be contacted if you are involved in an emergency?

Name

Daytime Phone

Relationship to you

Evening Phone

Address

Address Line 1

City

State

Zip Code

Position Details

Position Applying For

Full or Part -Time

Full Time
Part Time

Desired Salary

Please indicated whether this is an hourly, weekly, or annual amount (ie. $15 per hour or $25,000 per year)

Additional Information

Who referred you to our company?

Do you have any friends or relatives who work here?

No
Yes

Please list friends or relatives who work here:

Have you applied to our company previously?

No
Yes

When or how long ago did you apply?

Are you at least 18 years old?

No
Yes

How will you get to work?

Are you willing to work any shift, including nights and weekends?

No
Yes

Please state any schedule limitations:

If applicable, are you available to work overtime?

No
Yes

If you are offered employment, when would you be available to begin work?

If hired, are you able to submit proof that you are legally eligible for employment in the United States?

No
Yes

Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation?

No
Yes

What reasonable accommodation, if any, would you request?

Have you ever been convicted of a felony or misdemeanor?

No
Yes

THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.

Tell us a little more:

Please list what you were convicted of as well as when and where (city, state)

Applicant Employment History

List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment.

Most Recent Employer

Employer Name

Supervisor Name

Job Duties

Reason for Leaving

Dates of Employment

Address

Address Line 1

City

State

Zip Code

Second Most Recent Employer

Employer Name

Supervisor Name

Address

Address Line 1

City

State

Zip Code

Third Most Recent Employer

Employer Name

Supervisor Name

Address

Address Line 1

City

State

Zip Code

Applicant's Education and Training

College/University Name

Did you receive a degree?

No
Yes

Degree(s) received

High School/GED Name

Did you receive a degree?

No
Yes

Other Training:

Graduate, technical, vocational, etc.

Please indicate any current professional licenses or certifications that you hold:

Awards, Honors, Special Achievements:

Military Service:

No
Yes

References

Name (Reference #1)

Phone

Relationship

Address

Address Line 1

City

State

Zip Code

Name (Reference #2)

Phone

Relationship

Address

Address Line 1

City

State

Zip Code

Additional Considerations

Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer:

Upload Your Resumé

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Please share your resume, certifications or relevant documents. Acceptable file types are .png, .jpg, .doc, .xls, .ppt, .pdf.

Certification

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize Cortez Bait & Seafood Fish Market to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Manager, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Cortez Bait & Seafood Fish Market, except in a specific written contract of employment signed on behalf of the organization by its Manager, has the power to alter or vary the voluntary nature of the employment relationship.

Certification

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.

Signature Format

Type
Draw

Date