Jiffy Mart

JIFFY MART - JOB APPLICATION Please note: Fill out all fields. Please read BEFORE filling out application: I certify that all information provided by me is true and complete to the best of my knowledge. I authorize my previous employers and references to give any information regarding employment or educational record. I agree that this company and my previous employers will not be held liable in any respect if a offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions or answers made by myself on this application. I understand that this company will do a background check before offering a position with their company. My submission means I understand and authorize said background check. (I understand this is the FINAL step in the application process and will only be done if I am being seriously considered for a position.)

Name

Former Name

Phone

Domestic

International

Address

Domestic

International

Address

Are you 18 or older?

Are you at least 16 years of age?

Yes

What shifts are you available to work

What days are you available to work?

What position are you applying for?

Have you ever been convicted of a misdemeanor crime?

Date and details

Yes

Have you ever been convicted of a felony crime?

Date and details

Yes

NH Locations - Which site would you like to work at?

VT Locations

Have you worked for Jiffy Mart before?

When and at what location?

Yes

Please check off the highest level of education you have completed

Please provide 10 years of employment history or 3 previous employers.

Check here if you are not currently employed:

Employer Name

Position

Supervisor Name

May we contact your employer?

Supervisor Phone

Reason For Leaving

New Question

Add Current Employer Add Previous Employer

Welcome