Employment Application Form The Butcher's Market is an equal opportunity employer and will not discriminate against any applicant on the basis of any characteristic that is protected by State or Federal law. We offer Health Insurance including Vision & Dental, 401k, Supplemental Insurance and Food Discounts. We are currently hiring Butchers, Case Workers, Cashiers and Managers. Openings in all locations including our newest to open in N Raleigh at 1540 Dunn Rd. Position Applying ForButcherMeat CaseCashierManagerAssistant ManagerGeneral MangerKitchen Prep CookDate you can start* MM slash DD slash YYYY Name* First Last Current Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Address* Personal InformationAre you 18 years of age or older?* Yes No Do you have a valid driver's license?* Yes No Are there any hours or days of the week you cannot work? If yes, specify below.* Yes (please specify below) No Hours I am not available to work: Type of employment desired:* Full time Part time Desired Location Cary Holly Springs Raleigh N Raleigh at Bedford Wake Forest Wilmington All Salary Desired: Are you employed now?* Yes No May we contact your present employer? Yes No Business Name, Contact & Phone Number of Current Employer:Do you have US Military experience?* Yes No Military Branch Served: Are you lawfully entitled to be employed in the United States?* Yes No Have you ever been convicted of a crime other than a minor traffic violation?* Yes No Please state citation, date and place where offense occured:* EducationHigh School: Name and location of High School* High School: Did you graduate?* Yes No College: Name and location of School College: Number of years attendedCollege: Did you graduate? Yes No College: Major Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you feel will be helpful to us in considering your application.References List three individuals not related to you, whom you have known for at least one year:Reference #1 Name: First Reference # 1 Address: Reference # 1 Phone:Reference # 1 - Number of years aquainted:Reference # 2 Name: First Reference # 2 Address: Reference # 2 Phone:Reference # 2 - Number of years aquainted:Reference # 3 Name: First Reference # 3 Address: Reference # 3 Phone:Reference # 3 - Number of years aquainted:Current & Former Employers (List most recent first)Employer # 1 Employer #1 - Name: Employer #1 - Address: Employer #1 - Phone:Employer #1 - When employed (date range): Employer #1 - Starting/Ending Salary: Employer #1 - Last position held/ responsibilities:Employer #1 - Reason for Leaving: Employer #2 Employer #2 - Name: Employer #2 - Address: Employer #2 - Phone:Employer #2 - When employed (date range): Employer #2 - Starting/Ending Salary: Employer #2 - Last position held/ responsibilities:Employer #2 - Reason for Leaving: Employer #3 Employer #3 - Name: Employer #3 - Address: Employer #3 - Phone:Employer #3 - When employed (date range): Employer #3 - Starting/Ending Salary: Employer #3 - Last position held/ responsibilities:Employer #3 - Reason for Leaving: May we contact the employers listed? Yes No Specific instruction about which employers we may or may not contact: Read and initial the following statements carefully before signing. In accepting the following you agree that you fully understand. I understand that the position I am applying for requires heavy lifting. I certify that am willing and able to lift 60 pounds comfortably* I am able I am not able I certify that the facts contained in this application are true, accurate, and complete to the best of my knowledge and understand that, if employed, falsified statements or omitted material facts on this application may result in my disqualification from consideration for employment, or termination from employment if I have been hired. I agree I understand and agree that, if hired, my employment is AT-WILL, is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated with or without cause, at any time, with or without notice. This provision supersedes any oral or written representation to the contrary unless in writing and signed by both the President of the company and the person to whom the writing is directed.* I understand I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted,* to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to the Company.* I agree PhoneThis field is for validation purposes and should be left unchanged. Δ
