Skills and Qualifications
Summarize any special training skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the
position for which you are applying.
List name and telephone number of three business/work references who are NOT related to you and are NOT previous supervisors. If not
applicable, list three school or personal references who are not related to you.
ist any additional information you would like us to consider,
certify that all information provided in order to apply for and secure work with the employer is true, complete and correct.
I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient
cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from Market Broiler’s service, whenever it is
I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all
references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify
the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I
may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the
employment process and all other persons, corporations or organizations for furnishing such information about me.
I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of
limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for only 30 days. At the end of that time, if I have not heard from the employer and still wish
to be considered for employment, it will be necessary to reapply and fill out a new application.
It is my understanding that PROVIDER CONTRACT FOOD SERVICE is an at-will employer and by understanding this it has been
explained to me that if I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the
employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be
required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I
understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral
or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that
federal immigration laws require me to complete an I-9 Form in this regard.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Signature of Applicant Date / / .
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