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Application for Employment - Mount Vernon

Baker's IGA is a Drug Free Workspace.

All portions of this application pertaining to you must be completed.  We appreciate the time you will spend in completing this application.  It is the policy and practice of this Company to provide all qualified employees and applicants for employment with equal employment opportunities without regard to age, race, religion, color, sex, pregnancy, ancestry, national origin, disability or any other status or condition protected by applicable law.  We provide upon request, reasonable accommodations to assist applicants with a disabilities in applying for employment.





Employment Record

(Please list most recent position first)

Employer #2:

Employer #3

Personal References

(not former employers or relatives)

Reference #1

Reference #2

Reference #3

Military Information

Security Information

(Conviction of a felony or misdemeanor will not automatically disqualify you from consideration of employment)

Read before submitting

This application will become inactive after 60 days.  If you wish to be considered for employment, after that time, you must complete a new application for employment.  All applications will, however, be retained in our files for a period of twelve months.

This company does not discriminate against qualified applicants or employees on the basis of race, creed, national origin, sex, ancestry, pregnancy, sex, color, age or other status or condition protected by applicable law.  However, we insist that all of our employees can perform the essential functions of their employment and have the character, integrity, and general reputation of honesty of a person we would be willing to have represent our company in its dealings with our clients, affiliates, suppliers and/or other employees.  Accordingly, we insist on complete honesty.  ANY LATER DISCOVERY THAT AN APPLICANT WAS NOT HONEST IN COMPLETING THIS APPLICATION WILL BE GROUNDS FOR DISCHARGE.


I authorize or instruct this company to make whatever inquiries it deems necessary (or any former employer, personal reference, or school official named in this application or referred by a person named in this application) in order to verify any information in my application and/or determine my qualifications and abilities and I agree to release and hold harmless those entities from any and all liability arising from the release of such information.  I understand that such inquiries may include information as to my character, general reputation or personal characteristics.  Statements I made on the application are true and complete.  I understand that if, in the judgment of the Company, I have made any false statements, omissions, concealments, or misrepresentations or I have failed to answer any questions fully and accurately, or results of such investigation are not satisfactory, any offer made by the Company may be withdrawn or my employment with the Company be terminated immediately, without any obligation to me other than for payment at the rate agreed upon for services rendered after I have been employed.  I agree to conform to the rules and regulations of the Company, and understand that, if I am hired, my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at the option of either the to enter into any agreement for employment for any specific period of time unless such agreement is in writing and signed by the Company's designated representative.





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