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Name Candidate's Name s/register">Available: Register for Free
Title United States High School
Target Location US-FL-Deltona
Email Candidate's Name s/register>Available with paid plan
Phone Candidate's Name s/register">Available with paid plan
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Employment ApplicationCandidate's Name
EDUCATIONPosition: STORE ASSOCIATEName: Kretzmer, Matthew RobertPresent Address: Street Address  County: United StatesBorough/Township:Email: EMAIL AVAILABLESSN: XXX-XX-8410Home Telephone: PHONE NUMBER AVAILABLEOther Telephone Type: Select Other Telephone TypeOther Telephone: --Education Name andLocationGraduate(Yes/No)Diploma/Degree/ GED/Certification/No. ofCreditsCourse/MajorName AtGraduationHigh School Pine RidgeHigh SchoolYesCollege/UniversityBusiness/Trade/TechnicalNursing/MedicalGraduateWork orOther (incl.Military)BACKGROUNDIF NO; WHY DID YOU LEAVE YOUR LAST JOB? Never had a job SkillsARE YOU VACCINATED AGAINST COVID-19?YesWHAT SHIFT ARE YOU MOSTINTERESTED IN WORKING?ANYARE YOU ABLE TO TRAVEL TOANOTHER STORE IF NEEDED? (NOTREQUIRED)NoARE YOU AVAILABLE TO WORKWEEKENDS?YesIF HIRED, WHEN COULD YOU START? As soon as possible ARE YOU LEGALLY ELIGIBLE TO WORKIN THE UNITED STATES?YesARE YOU CURRENTLY WORKING? NoDO YOU HAVE ANY FRIENDS/RELATIVESTHAT WORK HERE?NoARE YOU 18 YEARS OF AGE OR OLDER? YesI UNDERSTAND AND ACKNOWLEDGETHAT AS A CONDITION OFEMPLOYMENT, I WILL OR MAY BESUBJECT TO A BACKGROUND ANDDRUG SCREEN THAT WILL REQUIRECLEAR RESULTS.. FURTHERMORE, IUNDERSTAND THAT THIS IS A DRUGAND ALCOHOL-FREE WORKPLACE.CHECK YES TO ACKNOWLEDGE.YesHard workingCommunicationTeamworkerLICENSE INFORMATIONNo License Information EnteredEMPLOYMENT INFORMATIONNo Employment history enteredATTACHMENTSNo AttachmentsCERTIFICATIONUnder pain of perjury, I, Matthew Robert Kretzmer, do certify that I have electronically signed this application and that the information is true and correct to the best of my knowledge, information and belief. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal. I agree to the these termsDate: 10-05-23ACKNOWLEDGMENT Candidate's Name ), and its designated agents and representatives at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university(public or private), information service bureau, employer, or insurCandidate's Name . I agree that a facsimile ("fax"), electronic or photographic copy of this Authorization shall be as valid as the original.New York applicCandidate's Name  by contacting the consumer reporting agency identified above directly. By signing below, you acknowledge receipt of Article 23-A of the New York Correction Law.https://www.criminaljustice.ny.gov/pio/correction-law-article-23a.pdf New York City applicCandidate's Name .Washington State applicants only: You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.Minnesota Candidate's Name s.https://bca.lacity.org/Uploads/fciho/Ban%20the%20Box%20Poster%20-%20Private%20Employers%2C%20as%20of%208.23.18.pdfSan Francisco residents/applicants only: View the San Francisco Fair Chance Ordinance.https://sfgov.org/olse/sites/default/files/FCO%20poster2020_0.pdf Signature: Matthew RobertKretzmer(ip: PHONE NUMBER AVAILABLE date:10/05/2023 03:47 PM)Date: 10/5/2023Printed Name: Matthew RobertKretzmerDISCLOSURE REGARDING "INVESTIGATIVE CONSUMER REPORT" BACKGROUND INVESTIGATIONFMS - Ascend Grocery, LLC [Employer and its designated agents and representatives] (the"CompCandidate's Name s and associates, and other information sources. The investigative consumer report may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company. You have the right, upon written request made within a reasonable time, to request (1) whether an investigative consumer report has been obtained about you, (2) disclosure of the nature and scope of any investigative consumer report and (3) a copy of your report. These reports will be conducted by HR Screening Services, Inc., 521 Cedar Way, Oakmont, PA 15139, 800-261-6268, www.hrscreening.com . This disclosure is not limited to your application for employment, but is intended to allow the Company to obtain, from any outside organization, types of investigative consumer reports throughout the course of your employment except to the extent prohibited by law. Signature: Matthew RobertKretzmer(ip: PHONE NUMBER AVAILABLE date:10/05/2023 03:47 PM)Date: 10/5/2023Printed Name: Matthew RobertKretzmer

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