Sample Page

Employment History

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Resume *

Click or drag a file to this area to upload.

Data Protection Statement

Crown Valley Market processes personal data that you voluntarily submit via our website only for recruitment purposes. Your personal data application will be active for a period of 90 days and retained thereafter as required by law. Crown Valley Market has contracted with a third party to host the database where applications are stored. The third party has access to that data if necessary to perform its services. The third party is contractually obliged to provide for the confidentiality and security of your data. *

I agree to the above

Are you under the age of 18? *

Yes
No

Did you graduate from High School or receive a GED? If you indicate Yes you will be required to complete an Education History. *

Yes
No

What is your highest level of completed education? *

Are you authorized to work in the United States? *

Yes
No

Do you have prior employment with any employer? *

Yes
No

If you indicate Yes, you will be required to provide your previous Employment History information. This would also include Military Service or Reserve Service or volunteer experience.

Employment History information *

The hiring process may consist of a phone interview, manager(s) interview, reference checks, and potential employment assessment. Are you willing to participate in this process? *

Yes
No

I certify that all information I have provided to Crown Valley Market in support of my application for employment is true and accurate. *

Yes
No

Electronic Signature Disclaimer

This notice is intended to provide you with important information required by the Electronic Signatures in Global and National Commerce Act (E‐Sign Act). Consent: By entering your name, you consent to submit your employment application and all related forms, documents, and information electronically. You further consent to conduct any matters related to the recruiting, application, background check and/or onboarding process, and any documents regarding employment if I am hired, electronically. Typing your name in the textbox under or on a form, entering your login password, and clicking on "Submit", will constitute your electronic signature. Right to Withdraw Your Consent: You have the right to withdraw your consent to receive disclosures and submit information electronically. If you choose to withdraw your consent, the application process will be terminated. You may withdraw your consent by contacting the Company, and typing in "Withdraw" in the textboxes for the Certification and Background Disclosure pages. Technical Requirements: To use this online process and to access and retain electronic records, you will need Microsoft Internet Explorer 7.0 or 8. You must also have access to a printer and/or the ability to download information in order to keep copies of the electronic agreements and disclosures for your records. Paper Copies of Electronic Records: If you wish to obtain a free copy of your electronic application and disclosure forms, you may click on the "print" link on the manage your application page. Updating contact information: It is your responsibility to update the Company regarding any changes to your e‐mail address or other contact information.

Signature

Employment History

Data Protection Statement

Electronic Signature Disclaimer

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