Fillable Printable IGA Job Application Form
Fillable Printable IGA Job Application Form
IGA Job Application Form
IGA is an Equal Opportunity Employer and will not discriminate on the basis of race, color, religion, sex, national origin,
disibility, veteran status, age, marital status, sexual orientation or other legally protected characteristics.
I understand that by filling out this application there is no guarantee that I will be hired. IGA reserves the right to withdraw
any offer of employment at any time; similarly, the applicant has the right to withdraw this application at any time. If you wish to submit
a resume, you may attach it to this application but, in addition, you must complete this application, including
employment history, and answer all questions fully and accurately.
NAME
LASTFIRSTMIDDLEOTHER NAMES UNDER WHICH YOU HAVE WORKED
ADDRESS
NUMBER AND STREET APT #CITYSTATEZIP CODE
TELEPHONE #SOCIAL SECURITY #
POSITION(S) DESIRED:
I AM AVAILABLE FOR:DATE AVAILABLE FOR WORK:
FULL TIMEPART TIMEON-CALL
DAYSNIGHTSGRAVEYARD
WEEKENDSHOLIDAYS
Have you ever been employed by IGA?YesNoIf yes, when?Dept?
Are you legally permitted to be employed in the United States?YesNo
(If hired, we will require verification of employment eligibility.)
If hired for a position involving the handling and/or serving of alcoholic beverages, Arizona Law requires you to be
at least 19 years of age. Do you qualify?YesNo
Have you been convicted of a felony in the last 7 years?
YesNo
If yes, please explain fully (Note: A conviction does not necessarily prohibit employment.)
LAST YEAR DEGREE
EDUCATIONSCHOOL ATTENDEDCITY/ STATECOMPLETEDRECEIVEDMAJOR / MINOR
HIGH SCHOOL9 10 11 12
COLLEGE/ UNIVERSITY1 2 3 4
OTHER1 2 3 4
SPECIAL TRAININGSKILLS
CalculatorTyping ______ words per minute
List any skills that may enhance your qualifications for
Cash registerShorthand ______ words per minuteemployment. These may include, but are not limited to fluency
PBX console10-Key adding machinein a language other than English.
Dictation equipmentComputer - (list software)
EMPLOYMENT HISTORY
Start with the most recent employer. All first time must be accounted for. Include part-time, tempory and contract
positions.
Date Hired:NAME OF EMPLOYERNAME AND TITLE OF IMMEDIATE SUPERVISOR
MoYr
Date Left:ADDRESS OF EMPLOYERPHONEREASON FOR LEAVING
MoYr
POSITION HELD AND DUTIESMay we contact this employer?
YesNo
Date Hired:NAME OF EMPLOYERNAME AND TITLE OF IMMEDIATE SUPERVISOR
MoYr
Date Left:ADDRESS OF EMPLOYERPHONEREASON FOR LEAVING
MoYr
POSITION HELD AND DUTIESMay we contact this employer?
YesNo
Date Hired:NAME OF EMPLOYERNAME AND TITLE OF IMMEDIATE SUPERVISOR
MoYr
Date Left:ADDRESS OF EMPLOYERPHONEREASON FOR LEAVING
MoYr
POSITION HELD AND DUTIESMay we contact this employer?
YesNo
Date Hired:NAME OF EMPLOYERNAME AND TITLE OF IMMEDIATE SUPERVISOR
MoYr
Date Left:ADDRESS OF EMPLOYERPHONEREASON FOR LEAVING
MoYr
POSITION HELD AND DUTIESMay we contact this employer?
YesNo
Have you ever been fired, dismissed, asked to resign or otherwise terminated from any job?YesNo
(Note: A yes answer does not necessarily prohibit employment.) If yes, what job, when and why?
Please advise us of your wage requirements. From:$to $
DateSignature
