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Personal Information
Full Name :  

Gender :
Male Female
Address :
City :
State :
Zip Code :
Phone Number :
Email Address :
Are You under 18 years of age?
Yes No
Please state your date of birth (mm/dd/yy)
Are you now in school or taking courses?
Yes No
If Yes School Name :
When will you finish the program?
Course hours you are committed to per week :
Basic Computer knowledge?
Yes No
If Yes rate yourself :
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Emergency Contact Name :
Phone :
Are You eligible to work in USA?
Yes No
Employment History
Have you ever been employed by any other Indian grocery store or Indian Food Retailor business in USA?
Yes No
Who have you recently worked for:
Employer Name:
Job Title:
Employed From (dd/mm/yyyy)- To (dd/mm/yyyy):
Reason for leaving employment:
JOB INTEREST Positions are open to individuals who are authorized to work in USA.
For which position are you applying?  

Please indicate what hours you are available to work?
Mon Tue Wed Thu Fri Sat Sun
From
To
Are you willing to work on holidays?
Yes No
Are you willing to work on weekends (Sat-Sun)?
Yes No
Would you work Full- Time or Part-Time?
FT PT
If hired, when can you start? (DATE)(mm/dd/yy)
Number of hours available per week :
Minimum Maximum
We require our employees to work as a team, respect each other’s individually, have fun , and make customers feel welcomed. Are you willing to go along with this?
Yes No
If hired, are there any obligations which would prevent you from reporting to work each day on time to perform your job duties?
Yes No
We have a no cell phone policy within the store. Are you willing to work with that?
Yes No
Are you open to work at all locations of India Bazaar?
Yes No
Your preferred IB location :  

I certify that information contained in this application is true and complete to the best of my knowledge. I understand that false information may lead to a possibility for not hiring me or immediate termination of employment at any point in the future if I am hired. I authorize the verification of all information listed above.


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