Welcome to the Rosauers Online Employment Application Form. (*) indicates required fields.
Today's Date:(*)
First Name:(*) Last Name:(*) Middle Initial:(*)
Email Address:(*) Date of Birth: (optional until hired)
Home Phone:(*) Mobile Phone:
Have you ever been employed by Rosauers/ Super 1/ Huckleberry’s? (*) Please Select Yes No
If you answered yes, which location? Select Location WA, Spokane - North Division WA, Spokane - North Francis WA, Spokane - Browne's Addition WA, Spokane - Huckleberry's WA, Spokane - 14th Ave. WA, Spokane - Super One Foods. WA, Spokane - Lincoln Heights WA, Spokane - East Sprague WA, Colfax WA, Walla Walla Wa, Colville WA, Deer Park WA, Ellensburg OR, Hood River ID, Moscow ID, Lewiston MT, Libby MT, Kalispell MT, Bozeman
Dates Employed:
From: Month:(*) Select Month January February March April May June July August September October November December Year:(*) To: Month:(*) Select Month January February March April May June July August September October November December Year:(*)
Please initial here if you are willing to take a pre-hire insta drug test and criminal background check.
Please read carefully and initial below:
1. I certify that the information given in this application and in any attachments, supporting documents or interviews are (or will be) true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission, as well as any misleading statements or omissions, generally will result in denial of employment, withdrawal of any offer of employment, or immediate termination, regardless of when and how discovered.
2. I authorize the investigation of all matters which Rosauers deems relevant to my qualifications for employment, including all information given in this application and in any attachments, supporting documents or interviews. I authorize you to request and receive such information and I release from all liability any persons (such as current or former supervisors, co-workers, etc.), employers or other such entities (schools, military, etc.) supplying it. I also release Rosauers Supermarkets, Inc. from all liability that might result from making the investigation.
3. I understand that I may resign or be terminated, without cause or notice, at any time, unless otherwise stated in a collective bargaining agreement or an employment contract. I also understand that the Vice‑President of Human Resources along with the President and CEO are the only persons who will ever have the authority to agree to any other terms and/or enter into such agreements or contracts and that all such agreements (collective bargaining agreements or agreements for other terms of employment) or contracts must be in writing and signed by both parties. I also understand that unless otherwise stated in a collective bargaining agreement or employment contract, the Company may change, withdraw and interpret other policies (including wages, hours and working conditions) as it deems appropriate.
4. I understand and agree that specifications pertaining to uniform, attire and personal appearance are at the discretion of the management.
5. Rosauers does not discriminate against applicants on the basis of disabilities unrelated to the essential functions of the job for which they are applying. In addition, Rosauers does not require that information relating to the physical or mental condition be disclosed in applying for employment. Preliminary offers of employment will be made without knowledge of, or regard to any applicant’s disability. You should understand that if you are offered a position in one of the job categories for which Rosauers does require a pre-employment medical examination, test, or imposes physical and other criteria to demonstrate through such examining or testing, that you are qualified (or with reasonable accommodation, would be qualified) to perform the essential functions of the job.
6. I understand and agree that I may be required to submit to pre- or post-employment physical or other professional examinations, medical inquiries and/or urinalysis tests for the presence of drugs and/or alcohol.
IMPORTANT: This means that with very few exceptions – for example, operations located in any state where it may be lawful – an employee will be required to submit to testing in several different circumstances. You may ask to see a copy of our employee Alcohol and Drug Policies if you have any questions. To be considered, you must agree to such examinations, inquiries and/or testing at the Company’s expense. By signing this application, you are authorizing release of the results to the Company and their use to evaluate your suitability for employment. You are releasing the Company from all liability arising out of, or connected with any examinations, inquiries and/or testing.
If you agree to disclosure above, please inital here:
PERSONAL INFORMATION:
Present Address: (*) City:(*) State:(*) Select State AL Alabama AK Alaska AS American Samoa AZ Arizona AR Arkansas CA California CO Colorado CT Connecticut DE Delaware DC District of Columbia FM Fed. States of Micronesia FL Florida GA Georgia GU Guam HI Hawaii ID Idaho IL Illinois IN Indiana IA Iowa KS Kansas KY Kentucky LA Louisiana ME Maine MH Marshall Islands MD Maryland MA Massachusetts MI Michigan MN Minnesota MS Mississippi MO Missouri MT Montana NE Nebraska NV Nevada NH New Hampshire NJ New Jersey NM New Mexico NY New York NC North Carolina ND North Dakota MP Northern Mariana Is. OH Ohio OK Oklahoma OR Oregon PW Palau PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VT Vermont VA Virginia VI Virgin Islands WA Washington WV West Virginia WI Wisconsin WY Wyoming Zip:(*)
Permanent Address:(*) City: (*) State:(*) Select State AL Alabama AK Alaska AS American Samoa AZ Arizona AR Arkansas CA California CO Colorado CT Connecticut DE Delaware DC District of Columbia FM Fed. States of Micronesia FL Florida GA Georgia GU Guam HI Hawaii ID Idaho IL Illinois IN Indiana IA Iowa KS Kansas KY Kentucky LA Louisiana ME Maine MH Marshall Islands MD Maryland MA Massachusetts MI Michigan MN Minnesota MS Mississippi MO Missouri MT Montana NE Nebraska NV Nevada NH New Hampshire NJ New Jersey NM New Mexico NY New York NC North Carolina ND North Dakota MP Northern Mariana Is. OH Ohio OK Oklahoma OR Oregon PW Palau PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VT Vermont VA Virginia VI Virgin Islands WA Washington WV West Virginia WI Wisconsin WY Wyoming Zip:(*)
Previous Address: City: State: Select State AL Alabama AK Alaska AS American Samoa AZ Arizona AR Arkansas CA California CO Colorado CT Connecticut DE Delaware DC District of Columbia FM Fed. States of Micronesia FL Florida GA Georgia GU Guam HI Hawaii ID Idaho IL Illinois IN Indiana IA Iowa KS Kansas KY Kentucky LA Louisiana ME Maine MH Marshall Islands MD Maryland MA Massachusetts MI Michigan MN Minnesota MS Mississippi MO Missouri MT Montana NE Nebraska NV Nevada NH New Hampshire NJ New Jersey NM New Mexico NY New York NC North Carolina ND North Dakota MP Northern Mariana Is. OH Ohio OK Oklahoma OR Oregon PW Palau PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VT Vermont VA Virginia VI Virgin Islands WA Washington WV West Virginia WI Wisconsin WY Wyoming Zip:
Driver License #:(*) If you were referred, by whom?
If you are hired, are you prepared to present evidence that you are legally authorized to work in the United States? (*)
Please Select Yes No
Preference of Worksite Location: (*)
Name: (*) Address: (*) Phone: (*)
ADDITONAL INFORMATION:
May we contact your present employer? (*) Please Select Yes No
Are you available for work any time of day and every day of the week? (*) Please Select Yes No
If no, list restrictions below:
Current Status:(*) Please Select JourneyMan Beginner Apprentice Salary expected to start:(*)
Some positions may not be held by certain individuals to avoid the possibility of conflicts of interest. Do you have a spouse, relative, or roommate currently working for us? (*) Please Select Yes No
If yes, what are their name(s) and your relationship to them?
Name: Relationship:
Do you have a minor work permit?(*) Please Select Yes No Do you have a health card?(*) Please Select Yes No
Do you have a birth certificate or other proof of age? (*) Please Select Yes No
Employment History
Position1
Hire Date: Month:(*) Select Month Jan Feb March April May June July August September October November December Day:(*) Year:(*)
End Date: Month:(*) Select Month Jan Feb March April May June July August September October November December Day:(*) Year:(*)
Business Name:(*) Address:(*)
City:(*) State:(*) Select State AL Alabama AK Alaska AS American Samoa AZ Arizona AR Arkansas CA California CO Colorado CT Connecticut DE Delaware DC District of Columbia FM Fed. States of Micronesia FL Florida GA Georgia GU Guam HI Hawaii ID Idaho IL Illinois IN Indiana IA Iowa KS Kansas KY Kentucky LA Louisiana ME Maine MH Marshall Islands MD Maryland MA Massachusetts MI Michigan MN Minnesota MS Mississippi MO Missouri MT Montana NE Nebraska NV Nevada NH New Hampshire NJ New Jersey NM New Mexico NY New York NC North Carolina ND North Dakota MP Northern Mariana Is. OH Ohio OK Oklahoma OR Oregon PW Palau PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VT Vermont VA Virginia VI Virgin Islands WA Washington WV West Virginia WI Wisconsin WY Wyoming Zip:(*)
Phone:(*) Immediate Supervisor's Name:(*)
If this employer knew you by another name, please indicate:
Job Title at Beginning:(*) Job Title at the end:(*)
Description of work duties:(*)
What did you like best about your job?(*)
What did you like least about your job?(*)
Reason for leaving:(*)
Position 2
Hire Date: Month: Select Month Jan Feb March April May June July August September October November December Day: Year:
End Date: Month: Select Month Jan Feb March April May June July August September October November December Day: Year:
Business Name: Address:
City: State: Select State AL Alabama AK Alaska AS American Samoa AZ Arizona AR Arkansas CA California CO Colorado CT Connecticut DE Delaware DC District of Columbia FM Fed. States of Micronesia FL Florida GA Georgia GU Guam HI Hawaii ID Idaho IL Illinois IN Indiana IA Iowa KS Kansas KY Kentucky LA Louisiana ME Maine MH Marshall Islands MD Maryland MA Massachusetts MI Michigan MN Minnesota MS Mississippi MO Missouri MT Montana NE Nebraska NV Nevada NH New Hampshire NJ New Jersey NM New Mexico NY New York NC North Carolina ND North Dakota MP Northern Mariana Is. OH Ohio OK Oklahoma OR Oregon PW Palau PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VT Vermont VA Virginia VI Virgin Islands WA Washington WV West Virginia WI Wisconsin WY Wyoming
Phone: Immediate Supervisor's Name:
Job Title at Beginning: Job Title at the end:
Description of work duties:
What did you like best about your job?
What did you like least about your job?
Reason for leaving:
Position 3
Have you ever been terminated (or quit because you believed you might be terminated, or at an employer's request)? (*) Please Select Yes No
If yes, please identify the employer and explain the circumstances:
Employer:
Circumstances:
Have you ever been CONVICTED, PLED GUILTY or NO CONTEST, or FORFEITED BOND OR BAIL for any crime, whether classified as a felony, misdemeanor, or any other type of violation or offense? (*) Please Select Yes No
If yes, please give details:
Degrees, Licenses, Relevant Training or Education. Please specify where you acquired these skills.
Business machines you can operate:
If you have any computer skills, please list them here:
Submit!
