Complete all spaces on the form. Please indicate if a question is not applicable to you.
*This application is active for 60 days.
I certify that the information contained in this application is correct to the best of my knowledge, and understand that false statements or serious omissions made in the application or during the interview process are grounds for dismissal from employment, regardless of when discovered. I understand this application does not constitute a contract and if I am hired that my employment can be terminated with cause or notice at the discretion of either myself or the company.
I hereby authorize all current and former employers, educational institutions, law enforcement agencies, and/or
other government agencies to provide/release information regarding my employment, education, criminal conviction
record, driver’s license violations and motor vehicle records that may be in their possession to Kirk Market and/or its
agents. I understand that, if hired, this authorization will stay in effect throughout my employment with Kirk Market and/or its agents harmless for any result of a reference check.