Employment Application Form | Countryside Markets

We are always seeking talented, motivated and most importantly friendly individuals who will take pride in caring for our customer's needs.

We feel that if our employees are happy then they'll be friendly to our customers. This way we can provied the best shopping experience for our customers. We enjoy having our neighbors become our employees.

Join our team

Applicant Information

First Name

M.I.

Last Name

Age:

I am at least 16 years old

I am at least 18 years old

Select the option that applies to you.

Are you 21 years of age or older?

Yes

Street Address

Apartment/Unit #

City

State

ZIP

Phone

E-mail

Date Available

Position Applying For

Please select 'Open' if your desired position is not listed.

Location applying for

Poplar Grove

Durand

Departments interested in

Do you have any retail expirence?

No

Yes

If yes, what?

Have you ever worked for this company?

No

Yes

If yes, when?

How did you find about us?

Why would you like to work for us?

Previous Employment 1

Company

Phone

Street

City

State

ZIP

Supervisor

Job Title

Responsibilities

From

To

Reason for leaving

Previous Employment 2

Company

Phone

Street

City

State

ZIP

Supervisor

Job Title

Responsibilities

From

To

Reason for leaving

Previous Employment 3

Company

Phone

Street

City

State

ZIP

Supervisor

Job Title

Responsibilities

From

To

Reason for leaving

Education

High School

Name

Address

City

State

ZIP

From

To

Did you graduate?

No

Yes

College

Name

Address

City

State

ZIP

From

To

Did you graduate?

No

Yes

Degree

Other

Name

Address

City

State

ZIP

From

To

Did you graduate?

No

Yes

Degree

References

Reference 1

Full Name

Relationship

Company

Phone

Address

City

State

ZIP

Reference 2

Full Name

Relationship

Company

Phone

Address

City

State

ZIP

Disclaimer Section

Resume

Upload Resume

Upload requirements

"I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE. I ALSO UNDERSTAND AND AGREE TO ALLOW MY APPLICATION TO BE TRANSMITTED THROUGH THE INTERNET."

We are an Equal Opportunity Employer.

Accept