Employment Opportunities

Cubby's Info
 

Personal Data
Contact Information

First Name
Middle Initial
Last Name

Telephone (402) 555-5555

Present Street Address

Present Street Address 2 (Suite Number, Apartment Number, etc... )

City
State
Zip Code
Employment Eligibility
Are you a U.S. citizen or authorized to work in the U.S. on an unrestricted basis?
Yes No
Have you ever been convicted of a misdemeanor or a felony, or do you currently have any criminal cases pending?
If YES, please give the date, location, and disposition of your case.
Yes No
Position Information

Please select the current open position you are most interested in:
  
Blair - Cashier
Blair - Deli Team Member
Blair - Pizza Delivery
Corporate Office - Deli Team Member
Dakota Dunes - Cashier
Dakota Dunes - Deli Manager
Dakota Dunes - Deli Team Member
Dell Rapids - Cashier
Dell Rapids - Deli Team Member
Fremont - Cashier
Fremont - Cashier
Gothenburg Express - Cashier
Gothenburg Express - Deli Team Member
Gothenburg Truck Plaza - Cashier
Gothenburg Truck Plaza - Deli Team Member
Greenwood - Cashier
Greenwood - Deli Team Member
Mitchell East - Cashier
Mitchell West - Cashier
Mitchell West - Deli Team Member
Mormon Bridge - Assistant Manager
Mormon Bridge - Deli Manager
Mormon Bridge - Deli Team Member
Mormon Bridge - Maintenance  
Neligh - Store Manager
Norfolk - Cashier
Norfolk - Deli Team Member
North Cliff - Cashier
Odebolt - Cashier
Odebolt - Deli Team Member
Old Market - Baker
O'Neill - Assistant Manager
O'Neill - Cashier
O'Neill - Deli Team Member
Pender - Cashier
Pender - Deli Team Member
Percival - Cashier
Percival - Deli Team Member
Phil's Foodway - Cashier
Phil's Foodway - Meat Cutter / Butcher
Red Oak - Cashier
Redman - Cashier
Sioux City - Cashier
Sioux City - Store Manager
Syracuse - Assistant Manager
Syracuse - Cashier
Syracuse - Deli Team Member
Syracuse - Store Manager
Tea - Cashier
Tea - Deli Team Member
Wakefield - Cashier
Wakefield - Deli Team Member
Waverly - Cashier
West 12th - Cashier
West 12th Truck Stop - Cashier
West 49th - Cashier
Yutan - Cashier
Yutan - Deli Team Member

*I understand that applicants who do not meet the minimum qualifications of the position will not be considered for the position. Only those final candidates will be contacted.
Desired starting pay:  

  Per Hour OR Per Week
How many hours a week do you want to work?

10 20 30 40+
During what times are you available to work?

Days
7am-3pm

Evenings
3pm-11pm

Nights
11pm-7am

Weekends
Please mark the days you are NOT available to work.

Mon.

Tues.

Wed.

Thurs.

Fri.

Sat.

Sun.
When could you begin work?

 Pick a date

Are you at least 16 years of age?

  Yes No
Are you at least 19 years of age?

  Yes No
Are you at least 21 years of age?

  Yes No
Positions require minimal lifting ability (approx. 40 lbs.). Do you have any injuries or physical conditions that will impair your ability to lift products?

  Yes No
Employment History
Most Recent Employer


From (mo/yr)


To (mo/yr) 		 
Employer Name
Job Title

Duties

Street Address

Street Address 2 (Suite Number, Apartment Number, etc... )

City
State
Zip Code

Supervisor's Full Name
Supervisor Phone
(402) 555-5555

Reason for Leaving
Other Employer #1

From (mo/yr) 
To (mo/yr)
Employer Name
Job Title

Duties

Street Address

Street Address 2 (Suite Number, Apartment Number, etc... )

City
State
Zip Code

Supervisor's Full Name
Supervisor Phone
(402) 555-5555

Reason for Leaving
Other Employer #2

From (mo/yr) 
To (mo/yr)
Employer Name
Job Title

Duties

Street Address

Street Address 2 (Suite Number, Apartment Number, etc... )

City
State
Zip Code

Supervisor's Full Name
Supervisor Phone
(402) 555-5555

Reason for Leaving
Education
Did you graduate from high school or earn a GED?

Yes No
Did you graduate from college?

Yes No
How Did Your Hear About Us?
In-Store Promotion Recruitment Card Employee Referral Agency
Advertisement Rehire Internet Other
PLEASE READ CAREFULLY
 I hereby certify that the answers to the foregoing questions are true to the best of my knowledge and agree to have any of the statements checked by Cubby's unless I have indicated to the contrary.

I am aware that a more detailed investigation concerning background and credit may also be conducted, if applicable to the job for which I am applying, and I hereby authorize such an investigation.

I understand that employment is contingent upon satisfactory completion of reference checks and that, upon my written request, information on the nature and scope of an inquiry, if one is made, will be provided to me.

I understand that nothing contained in this employment application is intended to lead to or create an employment contract between Cubby's or any subsidiary or affiliate and myself which would in any way restrict the right of the company to terminate my employment at will.

I further understand and agree that the employment relationship that may result from my application will be employment-at-will, and either I or Cubby's or any subsidiary or affiliate may terminate the relationship at any time.

I understand that any omission, misrepresentation or falsification can be grounds for refusal of employment. I further understand that, if employed, any false statements or misrepresentations herein or in conjunction with the application process may be cause for dismissal.

I understand that any and all disputes regarding my employment with Cubby's, including any disputes relating to the termination of my employment, are subject to the Cubby's Company Policy. I also understand and agree, as a condition of employment and continued employment, to submit any such disputes in accordance with Company Policy.

Application Certification
Please type your initials and email address in the following boxes. By doing so and submitting this form to Cubby's you are agreeing to the terms and conditions stated above.
 
Your Initials
Email Address