Employment Application It is the policy of P&C Fresh to provide equal employment opportunities to all applicants and employees without regard to race, color, citizenship status, religion, sex, sexual orientation, marital status, age, national origin, status as an individual with a disability, or any other legally protected status as a disabled and/or Vietnam Era Veteran and to affirmatively seek to advance the principles of equal employment opportunity.Name* First Last Which P&C Location Are You Applying To?*P&C Fresh - CortlandP&C Fresh - IthacaAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Telephone*Cellular PhoneEmail* Are you at least 18 Years of Age?YesNoIf not, are you at least 16 years of age?YesNoIf under age 18, can you supply working papers?YesNoAre you legally eligible for employment in this country?YesNoHave you ever been employed by P&C Fresh?YesNoWhich Location?When did you leave? Date Format: MM slash DD slash YYYY Supervisor's Name?Why did you leave? Please be specific.Are you currently employed?YesNoHave you ever been discharged from any employment or asked to resign?YesNoIf yes, please explain.Previous EmployerPrevious Employer - Start Date Date Format: MM slash DD slash YYYY Previous Employer - End Date Date Format: MM slash DD slash YYYY Previous EmployerPrevious Employer - Start Date Date Format: MM slash DD slash YYYY Previous Employer - End Date Date Format: MM slash DD slash YYYY Best time to contact you? : HH MM AM PM Do you have any relatives employed by P&C Fresh?YesNoIf Yes, name of relative? Location?Daily AvailabilityEx: If you are able to work from 9am-5pm please put "9am-5pm"MondayTuesdayWednesdayThursdayFridaySaturdaySundayHave you even been convicted of a felony?YesNoIf yes, please explain.Have you been convicted of a criminal offense in the last five (5) years?YesNoIf yes, please explain.Have you been convicted of a criminal offense for which your period of incarceration ended within the past five (5) years?YesNoIf yes, please explain.Please Confirm* Falsification of any portion of this application will result in disqualification and/or termination if hired.
