Southside Produce Market Application for Employment

IDENTIFICATION

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Age {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Street Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

City {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

State {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Zip Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Have You Ever Been Convicted of a Felony? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Emergency Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

EMPLOYMENT DESIRED

Employment Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Desired Pay per Hour {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Any Objection to Working Overtime? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Can You Work Overtime Without Prior Notice? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Can You Work Saturday and/or Sunday? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

List Any Days You Cannot Work {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please List Any Special Requirements or Restrictions? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

EDUCATION

High School

Did You Attend High School? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# Years Attended {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Graduation Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Area of Study {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Higher Education

Did You Attend? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# Years Attended {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Graduation Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Area of Study {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Check to Add a 2nd Higher Education {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Higher Education 2

Did You Attend? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# Years Attended {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Graduation Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Area of Study {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Check to Add a 3rd Higher Education {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Higher Education 3

Did You Attend? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

School Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# Years Attended {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Graduation Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Area of Study {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

EMPLOYMENT HISTORY

Produce Experience

Any Produce Experience? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

List the Places Where You Have Prior Produce Experience {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Current Employment

Are You Currently Employed? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

May We Contact Your Present Employer? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Phone # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Start Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

End Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Pay Rate per Hour {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Reason For Leaving {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

DO YOU HAVE PREVIOUS EMPLOYERS? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Previous Employer(s)

Employer {binding ItemNumber}

Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Phone # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Start Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

End Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Pay Rate per Hour {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Reason For Leaving {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

AUTHORIZATION AND SIGNATURE

Signature (Type Your First and Last Name) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Date (Today's Date) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}