What positions are you applying for?

Front End / Cashier (always accepting)

Deli / Bakery (always accepting)

Name of Applicant *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

If hired, when would you be available to start work?

MM

DD

YYYY

What is your highest level of education?

High School

Some College

College Degree

Other

What is your current Employment Status?

Employed Part-Time

Employed Full-Time

Self-Employed

Unemployed

Student (Part-Time)

Student (Full-Time)

Verification *

By checking this box, I am confirming that the information provided in this application is true, correct and complete. I understand that any false or misleading information or omissions on this application may disqualify me from further consideration for employment and may be considered justification for dismissal at a later date. I further understand that if I am hired there is no employment contract and any verbal statements to the contrary are false. Employment is at will and may be terminated by either the company or by me at any time, with or without cause. I understand that my assigned hours, shifts and work location may change. I authorize Potsdam Consumer Cooperative, Inc. (Potsdam Food Co-op) to investigate any information contained in this application or obtained in an interview, to contact my former employers, and to conduct a background check and Social Security verification.