formVinceD2021-09-17T09:56:31-04:00Please enable JavaScript in your browser to complete this form.PERSONAL INFORMATIONFull Name *FirstMiddleLastCurrent Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSocial Security Number *Home PhoneCell PhoneBusiness PhoneEmail Address *What prompted you to apply? (check one only) *Walk-inSign PostedEmployee ReferralOtherName of EmployeeOtherPosition that you are applying for *Position that you are applying for #2Full-TimePart-TimeTemporaryFrom *MondayTuesdayWenesdayThursdayFridaywpforms-one-thirdSundayFrom *To *Day Available 2UnavailableMondayTuesdayWenesdayThursdayFridaySaturdaySundayFromToDay Available 3UnavailableMondayTuesdayWenesdayThursdayFridaySaturdaySundayFromToDay Available 4UnavailableMondayTuesdayWenesdayThursdayFridaySaturdaySundayFromToDay Available 5UnavailableMondayTuesdayWenesdayThursdayFridaySaturdaySundayFromToDay Available 6UnavailableMondayTuesdayWenesdayThursdayFridaySaturdaySundayFromToDate Available for WorkSalary Desired (Per Hour) $ Selected Value: 5Do you have a relative employed at DeVitis & Sons Inc?YesNoNamePositionHave you worked for DeVitis & Sons Inc previously?YesNoDatesDateTimeAre you at least 18 years of age?YesNoCan you furnish a work permit?YesNoDo you have a legal right to work in this country?YesNoProof of identity and employment eligbility will be required upon employmentDo you know or will you in the future require Visa sponsorship for employment?YesNoPlease explainIf there any time of the year where you require time off?YesNoGive dates and explainEDUCATIONHigh School (Completed)YesNoDegree / Certification ReceivedDiplomaGEDMajor / ConcentrationCollege / University (Completed)YesNoDegree / Certification ReceivedAssociatesMasterBachelorsDoctorateMajor / ConcentrationCollege / University (Completed)YesNoDegree / Certification ReceivedAssociatesMasterBachelorsDoctorateMajor / ConcentrationOtherYesNoPlease explainEMPLOYMENT HISTORYNote: A Resume will not substitute for this sectionList all work experience, military service, self-employment and periods unenployed during the last 15 years, beginning with the most recent. Volunteer work is considered valid work experience.Employment 1Company NameFromToTotal Time w/Company(yrs/mos)Salary Start $Salary Start RatehryrSalary End $Salary End RatehryrPositionSupervisor Name & TitleDutiesAddress(street, city, state, zip)Supervisor Phone NumberReason for leavingExplain time between jobsEmployment 2Company NameFromToTotal Time w/Company(yrs/mos)Salary Start $Salary Start RatehryrSalary End $Salary End RatehryrPositionSupervisor Name & TitleDutiesAddress(street, city, state, zip)Supervisor Phone NumberReason for leavingExplain time between jobsEmployment 3Company NameFromToTotal Time w/Company(yrs/mos)Salary Start $Salary Start RatehryrSalary End $Salary End RatehryrPositionSupervisor Name & TitleDutiesAddress(street, city, state, zip)Supervisor Phone NumberReason for leavingExplain time between jobsEmployment 4Company NameFromToTotal Time w/Company(yrs/mos)Salary Start $Salary Start RatehryrSalary End $Salary End RatehryrPositionSupervisor Name & TitleDutiesAddress(street, city, state, zip)Supervisor Phone NumberReason for leavingExplain time between jobsEmployment 5Company NameFromToTotal Time w/Company(yrs/mos)Salary Start $Salary Start RatehryrSalary End $Salary End RatehryrPositionSupervisor Name & TitleDutiesAddress(street, city, state, zip)Supervisor Phone NumberReason for leavingExplain time between jobsOTHER NAMES UNDER WHICH EMPLOYMENT, PROFESSIONAL LICENSE(S) OR CERTIFICATION(S), AND EDUCATION MAY BE VERIFIEDOTHER INFORMATIONALL APPLICANTSA conviction record will not necessarily be a bar to employment. Applicants with a sealed record on file can answer "no record" to any inquiries about criminal charges. Have you ever been convicted of a felony? *YesNo recordWithin the last five (5) years, have you been convicted of, or released from incarceration, for a misdemeanor which was NOT a first offense for drunkenness, simple assault, speeding, a minor traffic violation, an affray, or disturbing the peace? *YesNo recordPlease give details including date, location (city), nature of offense, and disposition:PRE-EMPLOYMENT DRUG TESTINGI understand that, as a condition of employment, I may be required to take a test for substances of abuse, except where prohibited by law.Signature *Clear SignatureOn entering the employ of DeVitis & Sons Inc., I agree to conform to the rules and regulations of the company and acknowledge that 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 company or myself. I understand that no policy, benefit, or procedure contained in any handbook creates an employment contract for any period of time, and no terms or conditions of employment contrary to the foregoing should be relied upon except for those made in writing by a designated officer of the company. All of the information on this application is truthful and factual and it is my understanding that should any falsification or material omission be discovered, it will constitute grounds for nonacceptance or dismissal.Signature *Clear SignatureAt DeVitis Market Inc., we value diversity in our organization, and we are an equal opportunity employer. We do not discriminate against any applicant because or race, religion, color, sex, sexual orientation, age, national origin, physical and/or mental disability, marital and/or familial status, pregnancy, and military status.Submit