| Full Name : |
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| Street Address : |
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| City : |
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| State : |
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| Zip Code : |
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| Phone Number : |
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| For which position are you applying? |
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| If hired, what pay rate do you desire per hour? |
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| Are You under 18 years of age? |
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| Please state your date of birth : |
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| Please indicate what hours you are available to work? |
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| Are you willing to work on holidays? |
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| Are you willing to work on weekends (Sat-Sun)? |
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| Would you work Full- Time or Part-Time? |
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| Would You prefer day or evening shifts? |
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| If hired, when can you start? (DATE) |
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| Number of hours available per week : |
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| JOB INTEREST |
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| We require our employees to work as a team, respect each others individually, have fun , and make customers feel welcome. Are you willing to go along with this? |
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| If hired, are there any obligations which would prevent you from reporting to work each day on time to perform your job duties? |
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| Have you ever been employed by any other Indian grocery store or Indian Food Retailor business in USA? |
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| If Yes , Please provide dates of employment : |
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| Name of store : |
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| Name of Manger : |
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| Why did you leave? |
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| Are you now in school or taking courses? |
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| If Yes School Name : |
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| When will you finish the program? |
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| Course hours you are committed to per week : |
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| Basic Computer knowledge? |
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| If Yes rate yourself : |
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| Emergency Contact Name : |
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| Phone : |
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| Are You eligible to work in USA? |
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| If No, please tell your current legal status : |
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| We have a no cell phone policy within the store. Are you willing to go along with this? |
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| Are you open to work at all locations of India Bazaar? |
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| Main Reason for this job: |
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| Your preferred IB location : |
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| I certify that information contained in this application is true and complete.
I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. |
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| Signature : |
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| Date : |
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