Job Application

Applicant Information

Please indicate which position you are applying for.

How did you hear about Federated Co-ops.

Please type your Last name.

Please type your First name.

Please type your Middle name.

Please type your home phone number, including area code (123-456-7890).

Please type your work phone number, including area code (123-456-7890).

Please type your cellular phone number, including area code (123-456-7890).

Please type in your current address.

Please type in your City.

Please type in your State.

Please type in your Zip Code.

Please type in your Email address.

Instructions
Contact us if you need help to fill out this application form or for any phase of the employment process. Every effort will be made to accommodate your needs in a reasonable amount of time.

1. Please thoroughly read all statements contained in this Application form.
2. Complete all pages of this form completely and accurately.
3. Print clearly. Incomplete or illegible applications will not be processed.
4. Do not fill out any other attached forms unless and until instructed.

Applicant Note:
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. This application applies only to the position specified. It is considered inactive after 365 days. If at any time after this point you wish to be considered for employment with this company, another application will have to be completed.

EEO Statement
We are an Equal Employement Opportunity employer, and do not discriminate in our hiring or employment practices. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, age, disability, sex, or any other characteristic protected by State or Federal law.

Availability

Please indicate whether you are legally authorized to work in the United States.

Please indicate if you are under the age of 18, and can provide proof of eligibility to work?

Please type in what date you are available to start working (mm-dd-yyyy).

Please select what schedule you would prefer, you may select multiple items.

Please select up to 3 Federated Co-ops location(s) you are applying for.

Education

Please select the highest grade of school that you completed.

High School Information

Please type in the name of the High School you attended.

Please type in the City and State of the High School you attended.

Please type in the name of the degree that you earned.

College Information

Please type in the name of the College you attended.

Please type in the City and State of the College you attended.

Please type in the name of the degree that you earned.

Other School Information

Please type in the name of any other Schools you attended.

Please type in the City and State of the other school you attended.

Please type in the name of the degree that you earned.

Job Related Skills

Employment History
Your application may not be considered unless every question is answered. Since we may contact previous employers, correct telephone numbers are essential.

Most Recent Employer
Second Most Recent Employer
Third Most Recent Employer

Business References - (DO NOT INCLUDE FRIENDS OR RELATIVES.)
Include only individuals familiar with your work capabilities.

Business Reference 1
Business Reference 2
Business Reference 3

Certification
I certify the answers given by me to the foregoing questions and any statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentations of facts regarding information called for in this application may result in rejection of my application, or discharge at any time during my employment. I also agree that, if company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. I understand that if I am hired, my employment shall be “at-will,” and that either the Company or I can choose to terminate the employment relationship for any reason, or no reason at all, with or without notice.

Authorization
I understand that background, drug, or medical testing may be conducted on me as part of the process to determine my fitness for employment, and hereby agree to submit to such testing. I authorize all persons, schools, companies, medical practitioners, current and/or former employers, and law enforcement authorities to release any information concerning my background or test results, and hereby release any said persons, schools, companies, medical practitioners, current and/or former employers, and law enforcement authorities from any liability for any damage whatsoever for issuing this information.

No signature required as this form will be submitted electronically.

You can attach your Resume if you wish.