Employment Application

Position Applying For:*
Date Available:*
MM slash DD slash YYYY
Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Business Phone
Mobile Phone
Are you 18 years of age or older? (If not, you may be required to provide work authorization.)*
- Yes
- No
If hired, can you provide verification of your legal right to work in the United States?*
- Yes
- No
Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation?*
- Yes
- No
Employment Information
List available days/hours:*
Preferred Job Status:*
- Full time
- Part Time
- Seasonal
- As needed
Education & Training
High School or GED Information:
College Information:
Graduate School Information:
Technical or Vocational School Information:
Describe any non-employment experience such as school or volunteer activities that might strengthen your application:
Certifications
Employment History
List all previous employment during the past seven years starting with the Employment History most recent. Use additional sheets if needed.
Employer 1*
Employer 1 Telephone*
Employer 1 Dates employed:*
Employer 1 Address:*
Employer 1 Job Title:*
Employer 1 Immediate Supervisor and Title:*
Employer 1, Summarize the nature of the work performed and job responsibilities.*
Employer 1, Reason for Leaving*
Employer 1, May we contact this employer?*
- Yes
- No
Employer 2
Employer 2
Employer 2 Telephone
Employer 2 Dates employed:
Employer 2 Immediate Supervisor and Title:
Employer 2 Address:
Employer 2, Summarize the nature of the work performed and job responsibilities.
Employer 2, Reason for Leaving
Employer 2, May we contact this employer?
- Yes
- No
Employer 3
Employer 3
Employer 3 Telephone
Employer 3 Dates employed:
Employer 3 Immediate Supervisor and Title:
Employer 3 Address:
Employer 3, Summarize the nature of the work performed and job responsibilities.
Employer 3, Reason for Leaving
Employer 3, May we contact this employer?
- Yes
- No
Please explain any gaps in your employment history.
What other business experience, personal experience or training have you had that may have prepared you for this position?
Personal Reference 1
Reference 1 Name:*
Reference 1 Occupation:*
Reference 1 Years Known:*
Reference 1 Years Address, City, State and Zip.*
Reference 1 Email:*
Reference 1 Phone:*
Reference 1 Alternate Phone:*
Personal Reference 2
Reference 2 Name:*
Reference 2 Occupation:*
Reference 2 Years Known:*
Reference 2 Years Address, City, State and Zip.*
Reference 2 Email:*
Reference 2 Phone:*
Reference 2 Alternate Phone:*
Personal Reference 3
Reference 3 Name:
Reference 3 Occupation:
Reference 3 Years Known:
Reference 3 Years Address, City, State and Zip.
Reference 3 Email:
Reference 3 Phone:
Reference 3 Alternate Phone:
Application Acknowledgement and Authorization*
I agree to the following:

We’re excited to open our second location in Geneva, Illinois.
This shop has the meats and products you love from our original Sublette location, plus full-service meat, seafood, and deli counters. We look forward to sharing our love of meat and good food with our helpful service at this Fox Valley store.

Sublette, IL

+1 815-849-5532
service@countryvillagemeats.com
Store Hours: Mon - Fri 8am - 5pm | Saturday 8am-12pm | Sunday: Closed
401 N. Pennsylvania Ave. Sublette, IL 61367
Facebook
Closed Thanksgiving

Geneva, IL

+1 630-345-6900
service@countryvillagemeats.com
Store Hours: Mon-Fri 10am-6:30pm* | Saturday 9am-5pm* | Sunday: Closed | *Deli Closes Half Hour Before Store Closing
715 East State Street, Ste 100 Geneva, IL 60134
Facebook
Instagram
Closed Thanksgiving

design by tony winstead

Employment Application

Employment Information

Education & Training

Employment History

Employer 2

Employer 3

Personal Reference 1

Personal Reference 2

Personal Reference 3

Sublette, IL

Geneva, IL