Name *

First Name

Last Name

Phone *

(###)

###

####

Alternate Phone

(###)

###

####

Preferred method you would like us to contact you regarding this application?

Phone

Email

Today's Date: *

MM

DD

YYYY

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you 18 years or older? *

Yes

No

Where? *

Tahoe City Market

Truckee Market

Crescent Cafe

Are you employed now? *

Yes

No

Date you can start: *

MM

DD

YYYY

Have you applied to this company before? *

Yes

No

Have you worked for this company before? *

Yes

No

Did you graduate?

Yes

No

Did you graduate?

Yes

No

Did you graduate?

Yes

No

Are you seeking short or long term employment? *

Seasonal (1-3 Months)

Seasonal (3-6 Months)

Seasonal (6+ Months)

Long Term (1 Year +)

Are you seeking full time or part time employment? *

Part Time (2-4 Shifts per week)

Full Time (5 Shifts per week)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Start Date:

MM

DD

YYYY

End Date:

MM

DD

YYYY

Check this box if you currently work with this employer.

I currently work with this employer.

May we contact your supervisor?

Yes

No

Supervisor's Phone Number:

(###)

###

####

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Start Date:

MM

DD

YYYY

End Date

MM

DD

YYYY

Check this box if you currently work with this employer:

I currently work with this employer.

May we contact your supervisor?

Yes

No

Supervisor's Phone Number:

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Check this box if you currently work with this employer:

I currently work with this employer.

May we contract your supervisor?

Yes

No

Supervisor's Phone Number:

(###)

###

####

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *

I agree and acknowledge the above statements.

I herby authorize New Moon Natural Foods to thoroughly investigate my references, work record, education and other matters related to my suitability for employment unless otherwise specified above. *

I agree and acknowledge the above statements.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. *

I agree and acknowledge the above statements.

Today's Date *

MM

DD

YYYY