a division of North State Grocery, Inc.
An Equal Opportunity Employer

ONLINE EMPLOYMENT APPLICATION

Holiday Market is committed to providing a healthy and productive environment for both its employees and customers. Accordingly, all applicants are advised that Holiday Market has adopted a non-smoking policy and that all stores and offices are smoke free.

Please review the following E-Verify Documents prior to completing the application
(clicking the link will open a new window/tab)

E-Verify Participation English Español
E-Verify Right to Work English Español

Personal Information


* indicates a required field

Location Applied For *

First Name
*
Middle Name

Last Name
*

Street Address
*
City State Zip
* * *
Length of time at Current Address


Do you have a current, valid Drivers License?
If Yes, DL Number and State of Issue


Phone Number
* must be formatted as 5305551212 (no hyphens or brackets)
Email Address

North State Grocery, Inc. is committed to providing its customers and employees with a safe and healthy environment free of the many hazards associated with tobacco smoke.

Do you currently smoke tobacco products? *

Were you Referred by an Employee? *
If you answered Yes to the above question, please indicate their name

Do you have any relatives working for Holiday?
If you answered yes to the above question, please indicate name and relationship

Have you previously been employed by Holiday Market?
If you answered yes to the above question, please indicate when and what location

Are you at least 18 years old? *
If you answered no to the above question, can you submit a work permit if hired? *

If hired can you present evidence of your U.S. citizenship or proof of your legal
right to live and work in this country? *
(proof of U.S. citizenship or immigration status will be required if hired)

Have you ever been terminated or disciplined because of sexual harassment in the workplace? *


Employment Interests


Position(s) applying for * *
(If you are applying for a retail hourly position, please keep in mind that the availability of hours may vary)

Date you can begin work? *

Rate of pay expected weekly? *

Are you willing to work rotating shifts and nights and/or weekends? *
If not, please explain why:

Do you have any interest in a management position? *
If you answered yes to the above question, please indicate what departments

Job duties of in-store employment positions are physically demanding, requiring at a minimum constant standing, frequent lifting up to 25 lbs and intermittent lifting up to 50 lbs as well as frequent bending and stooping.

Are you able to perform all job duties and functions of the job for which you are applying? *
If no, please describe the job duties and functions that cannot be performed and the accommodations you are requesting:

(Note: The Company complies with State and Federal laws regarding "reasonable accommodations" that
may be necessary for eligible applicants and employees to perform essential functions; however, the failure
to advise the Company of your inability to perform the essential job functions with or without a reasonable
accommodation may be considered misrepresentation. As a matter of Company policy, any such
misrepresentations may be the basis for terminating any employment offered.
)

If hired would you have a reliable means of transportation to and from work? *


Education, Training and Experience


Have you graduated from High School? * GPA: *
High School name and address

Did you attend college? GPA:
Degree(s) earned
If so, please indicate the college name and address

Did you attend a vocational / business school? GPA:
Degree(s)/Certificate(s) earned
If so, please indicate the college name and address

Do you have any other experience, training, qualifications or skills which you feel make
you especially suited for work at Holiday Market?

Do you speak more than one language fluently?    *
If so, what languages can you speak?

How long do you intend to work for Holiday Market? *

What is the number one reason you shop where you do? *

Define friendly service?*

Describe a specific situation where you have provided excellent customer service and
why this was effective?


Employment History
Please list below all present and past employment starting with your most
recent employer (10 years is sufficient)


Most Recent Employment

1: From To
Name and Address of Employer - Type of Business

Reason for leaving
Position / Duties Performed

Supervisors Name
Supervisors Phone Number May we contact

2: From To
Name and Address of Employer - Type of Business

Reason for leaving
Position / Duties Performed

Supervisors Name
Supervisors Phone Number May we contact

3: From To
Name and Address of Employer - Type of Business

Reason for leaving
Position / Duties Performed

Supervisors Name
Supervisors Phone Number May we contact

4: From To
Name and Address of Employer - Type of Business

Reason for leaving
Position / Duties Performed

Supervisors Name
Supervisors Phone Number May we contact?


Professional References
Please provide the names of three professional references,
whom you have known at least one year


1: Name
Address

Phone number
Business
Number of years acquainted

2: Name
Address

Phone number
Business
Number of years acquainted

3: Name
Address

Phone number
Business
Number of years acquainted


Please Read and Sign Below
Applicant Certification Authorizations and Understandings


I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I understand that any omission or misstatement of material facts on this application or any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.

I hereby authorize Holiday Market to thoroughly investigate my references, work records, education and other matters related to my suitability for employment and further, authorize my former employer to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation of disclosure.

I understand that nothing contained in the application or conveyed during my interview which may be granted is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without notice, at the option of either myself or the company, and that no promised or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative.  I also understand the company does not employ individuals who are current users of illegal drugs, and testing is required.

Important Note: Be advised, along with this application you will be required to sign a disclosure and authorization form enabling Holiday Market to obtain a consumer report and/or investigative consumer report. In addition, you will be required to submit to a drug screen.

I have read and fully understand the above *

Date *

Typed Name In Full *