Job Application • Harbor Fish Market

Application for Employment

draft 4/2023

AN EQUAL OPPORTUNITY EMPLOYER

Equal access to programs, services and employment opportunities is available to all persons without regard to race, religion, color, sex (including pregnancy), age, national origin, mental or physical disability, sexual orientation, gender identity, genetic information, or any other basis protected by federal, state and/or local law.

In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations include making a change to the application process; providing written materials in an alternate format such as braille, large print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions.

Required information is marked with an asterisk*

Contact Information

First Name*:

Middle Name:

Last Name*:

Street Address*:

City*:

State*:	Zip Code*:

Telephone*:

E-Mail Address*:

This email address does not get added to any of our marketing databases.

Best Time to Call You:

Can we contact you at work?*
YesNo

Employment Information

Position Applied For*:

Date of Application*:

Referral Source (e.g., walk-in, job posting, website)*:

Are you lawfully authorized to work in the United States?*
YesNo

Date available for work*:

If under 16, can you furnish a work permit?*
YesNoN/A

Have you submitted an application here before?*
YesNo

If so, when?

Will you work overtime, if required?*
YesNo

Are you able to meet the attendance requirements of the position?*
YesNoNeed more info

Type of employment desired*:
Full TimePart TimeSeasonal/Temporary

Are you able to perform the 'essential functions' of the job for which you are applying, with or without reasonable accommodation?*
YesNoNeed more info

Background Information

Driver's license number*:	State of issue*:

Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for Harbor Fish Market?*
YesNo

If yes, please explain:

Have you ever pleaded 'guilty' or 'no contest' to, or been convicted of, a crime?
YesNo
Answering ‘yes’ to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. You are not obligated to disclose juvenile records that have been expunged.

If yes, please provide details:

Employment History

Starting with your most recent employer, provide the following information.

Previous Employer 1*

Employer Name*:

Address*:

Phone*:

Position*:

Dates Employed*:

Reason for Leaving*:

Previous Employer 2

Employer Name:

Address:

Phone:

Position:

Dates Employed:

Reason for Leaving:

Previous Employer 3

Employer Name:

Address:

Phone:

Position:

Dates Employed:

Reason for Leaving:

Skills and Qualifications

Summarize any special skills and qualifications acquired from employment or other experiences that may qualify you for work with Harbor Fish Market:

Educational Background

Highest level of education completed:

High School
College/University
Graduate School
N/A

Starting with your most recent school attended, provide the following information:

School 1*

School Name*:

Address*:

Degree or Diploma*:

School 2

School Name:

Address:

Degree or Diploma:

School 3

School Name:

Address:

Degree or Diploma:

Other Information

Please list any other job-related information you want us to know about you:

References

List three business/work references who are not related to you.
If not applicable, list three school or personal references who are not related to you.

Reference #1*

Name*:

Relationship to You*:

Telephone Number*:

E-Mail Address*:

# Years Known*:

Reference #2

Name:

Relationship to You:

Telephone Number:

E-Mail Address:

# Years Known:

Reference #3

Name:

Relationship to You:

Telephone Number:

E-Mail Address:

# Years Known:

Resume or Cover Letter

(optional) Please upload your resume and/or cover letter in .pdf, .doc, or .docx format (max size: 2MB).

Choose a file:

Applicant Statement

I certify that all the information I have provided in order to apply for and secure work with Harbor Fish Market is true, complete and correct.

I expressly authorize, without reservation, Harbor Fish Market, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other person,s corporations, organizations for furnishing such information about me.

I understand that Harbor Fish Market does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law.

I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from Harbor Fish Market and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired I understand that I am free to resign at any time, with or without prior notice, and Harbor Fish Market reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of Harbor Fish Market is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that reasonable safeguards will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with Harbor Fish Market’s affiliate(s) and third parties engaged by the Harbor Fish Market to perform services for the Company. Any personal information shared with an affiliate or third party is to be used solely to perform the services requested by Harbor Fish Market.

Harbor Fish Market does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her race, religion, color, sex (including pregnancy), age, national origin, mental or physical disability, sexual orientation, gender identity, genetic information, or any other protected status under applicable federal, state, or local law.

I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered.

I certify that I have read and agree to the Applicant Statement above.
I agree

I agree to the use of an electronic signature.
I agree

If you prefer to sign in person, you may cancel this form (below) and fill out the application by hand at our physical location.

Signature:

Cancel

Application for Employment

draft 4/2023

AN EQUAL OPPORTUNITY EMPLOYER

Equal access to programs, services and employment opportunities is available to all persons without regard to race, religion, color, sex (including pregnancy), age, national origin, mental or physical disability, sexual orientation, gender identity, genetic information, or any other basis protected by federal, state and/or local law.

In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations include making a change to the application process; providing written materials in an alternate format such as braille, large print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions.

Required information is marked with an asterisk*

Contact Information

First Name*:	Middle Name:	Last Name*:

Street Address*:

City*:	State*:	Zip Code*:

Telephone*:	E-Mail Address*:

	This email address does not get added to any of our marketing databases.
Best Time to Call You:	Can we contact you at work?*
	YesNo

Employment Information

Position Applied For*:	Referral Source (e.g., walk-in, website)*:	Date of Application*:

Are you lawfully authorized to work in the United States?*	If under 16, can you furnish a work permit?*	Date available for work*:
YesNo	YesNoN/A
Have you submitted an application here before?*	If so, when?	Will you work overtime, if required?*
YesNo		YesNo
Are you able to meet the attendance requirements of the position?*	Type of employment desired*:	Are you able to perform the 'essential functions' of the job for which you are applying, with or without reasonable accommodation?*
YesNoNeed more information	Full TimePart TimeSeasonal/Temporary	YesNoNeed more information

Background Information

Driver's license number*:	State of issue*:

Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for Harbor Fish Market?*	If yes, please explain:
YesNo
Have you ever pleaded 'guilty' or 'no contest' to, or been convicted of, a crime?*	If yes, please provide details:
YesNo
	Answering ‘yes’ to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. You are not obligated to disclose juvenile records that have been expunged.

Employment History

Starting with your most recent employer, provide the following information.

Previous Employer 1*

Employer Name*:	Phone*:

Address*:

Position*:	Dates Employed*:

Reason for Leaving*:

Previous Employer 2

Employer Name:	Phone:

Address:

Position:	Dates Employed:

Reason for Leaving:

Previous Employer 3

Employer Name:	Phone:

Address:

Position:	Dates Employed:

Reason for Leaving:

Skills and Qualifications

Summarize any special skills and qualifications acquired from employment or other experiences that may qualify you for work with Harbor Fish Market:

Educational Background

Starting with your most recent school attended, provide the following information:

Highest level of education completed:

High School
College/University
Graduate School
N/A

School Name	Address	Degree or Diploma

Other Information

Please list any other job-related information you want us to know about you:

References

List three business/work references who are not related to you.
If not applicable, list three school or personal references who are not related to you.

Name	Relationship to You	Telephone Number	E-Mail Address	# Years Known

Upload Your Resume or Cover Letter