Job Openings — Lane Co. Community Grocery

Position Applied For

Employment Type *

Full-Time Part-Time Either

Date of Application *

Earliest Date You Could Start *

Desired Hourly Pay (range posted: $20–$25)

Last Name *

First Name *

Middle Initial

Street Address *

Apt/Unit

City *

State *

ZIP Code *

Phone Number *

Email Address *

Are you at least 18 years old? *

Yes No

Are you legally authorized to work in the U.S.? *

Yes No

Do you have reliable transportation to work? *

Yes No

Have you worked for Lane Co. Community Grocery before?

Yes No

Years of meat cutting / butcher experience *

Where did you get that experience? (grocery, locker plant, processing, home/farm, etc.)

Which of these have you done? (check all that apply)

Beef cutting Pork cutting Poultry Grinding / ground beef Sausage / smoked products Wild game processing Retail case display / merchandising Customer special orders Ordering / inventory

Equipment you are comfortable operating (check all that apply)

Band saw Slicer Grinder Tenderizer / cuber Vacuum sealer / wrapper Scale / label printer

Food safety certification? (ServSafe, food handler card, etc.)

Able to lift 50+ lbs and work in a cold environment? *

Yes No With accommodation

Anything else about your meat-cutting background we should know?

Store hours are Mon–Sat 7 a.m.–7 p.m. and Sun 11 a.m.–6 p.m. Check the times you can work.

Day	Morning	Midday	Afternoon/Evening	Not available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Hours per week you're looking for

Anything else about your schedule?

Level	School Name	Location	Years	Diploma/Degree
High School
College/Trade

Employer 1 (Most Recent)

Employer Name

Phone

Address

City, State, ZIP

Job Title

Dates Employed

Supervisor

Reason for Leaving

May we contact?

Yes No

Employer 2

Employer Name

Phone

Address

City, State, ZIP

Job Title

Dates Employed

Supervisor

Reason for Leaving

May we contact?

Yes No

Employer 3

Employer Name

Phone

Address

City, State, ZIP

Job Title

Dates Employed

Supervisor

Reason for Leaving

May we contact?

Yes No

Personal Reference *

Name

Relationship

Phone

Former Employer / Work Reference *

Name

Company / Relationship

Phone

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false statement or omission may disqualify me from employment or, if employed, may result in dismissal.

I authorize Lane Co. Community Grocery, Inc. to contact the employers and references listed above (except where I have indicated otherwise) and to verify the information I have provided. I understand that an offer of employment may be conditioned on a satisfactory background check.

I understand that employment with Lane Co. Community Grocery, Inc. is at-will, meaning either the company or I may end the employment relationship at any time, with or without cause or notice.

Electronic Signature (type your full name) *

Date *

I have read and agree to the statements above. *

Equal Opportunity Employer

Lane Co. Community Grocery, Inc. is an equal opportunity employer. We consider all applicants without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other status protected by law.

Employment Application

Meat Cutter

Employer 1 (Most Recent)

Employer 2

Employer 3

Personal Reference *

Former Employer / Work Reference *

Equal Opportunity Employer

Thank you — we got your application.