Employment Application

We are always looking for hardworking, dedicated individuals to join our team. We offer excellent benefits and a superior working environment.

Halsey Foodservice provides equal employment opportunity to qualified individuals without regard to race, color, religion, sex, (including pregnancy, childbirth, and related medical conditions), national origin, age, (40 and over), citizenship, physical or mental disability, or status as a disabled veteran of the Vietnam era.

In addition to completing the form below you may . Please ensure that your resume is in either PDF or Word document format and reference your job interest in the email.

 

Please fill out all fields of the application. (* Indicates a required field)

Date:
Applicant's Personal Data
*Name:
Present Address:
City:
State:
Zip:
*Phone:
*Email:
        Person to be Notified in Case of Accident or Emergency
Name:
Phone:
Address:
City:
State:
Zip:
Have you ever been convicted (including a guilty plea) of a crime, excluding misdemeanors? (A "yes" answer will not automatically disqualify you from being considered for employment with the Company.)
  YES    NO
If "Yes," give the date, place, and describe the offense:
Are you legally authorized to work in the United States? YES    NO
Are you over the age of 18? YES    NO

 

Job Information
Job Title applied for:
Rate of pay expected:
How were you referred to us?
Have you worked for us before? YES    NO
If yes, when?
List any friends or relatives working for us:
When are you available to start?
List any work experience, skills, or qualifications you feel especially qualify you for the job you are applying for.

 

Educational Background
HIGH SCHOOL Name and Address:
Years Attended:
Graduated:
Course/Major:
   
COLLEGE Name and Address:
Years Attended:
Graduated:
Course/Major:
   
POST GRADUATE Name and Address:
Years Attended:
Graduated:
Course/Major:
   
BUSINESS/TRADE Name and Address:
Years Attended:
Graduated:
Course/Major:
   
OTHER:

 

Military Service
Did you serve in the armed forces? YES    NO
If yes, what branch?
Dates of active duty: From   To
Rank at discharge:
What were your duties in the service (including special training and duty stations)?

 

Personal References (Excluding Former Employers or Relatives)
Reference 1 Name:
Address:
Phone:
   
Reference 2 Name:
Address:
Phone:
   
Reference 3 Name:
Address:
Phone:


Prior Work History (List in Order, Most Recent Employer First)
Employer 1 Dates: From   To
Rate of Pay: Start   Finish
Name:
Address:
*Phone:
Supervisor's Name and Title:
Reason for Leaving:
Describe in detail the work you did:
May we contact this employer? YES    NO
   
Employer 2 Dates: From   To
Rate of Pay: Start   Finish
Name:
Address:
*Phone:
Supervisor's Name and Title:
Reason for Leaving:
Describe in detail the work you did:
May we contact this employer? YES    NO
   
Employer 3 Dates: From   To
Rate of Pay: Start   Finish
Name:
Address:
*Phone:
Supervisor's Name and Title:
Reason for Leaving:
Describe in detail the work you did:
May we contact this employer? YES    NO

Authorization

I authorize investigation of all statements contained in this application. I understand that misrepresentation of information requested is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wage or salary, may be terminated at any time without any previous notice.

Applicants for positions that require driving a commercial motor vehicle (CMV) at any time will be required to undergo controlled substance and, at our discretion, alcohol testing prior to employment and will be subject to further testing throughout their period of employment. Applicants will also be asked to sign forms for release of information from previous employers in all cases where driving a CMV was one of your functions. Failure to sign will prevent us from using you as a CMV driver.

I accept:

Notice to Disabled Individuals, Disabled Veterans, and Veterans of the Vietnam Era

Click here to view and/or download a copy of our Notice to Disabled Individuals, Disabled Veterans, and Veterans of the Vietnam Era.

VOLUNTARY DISCLOSURE FORM
(Completion of this section is appreciated, but not required)

Halsey Foodservice is required by federal law to take affirmative action in its employment policies. To comply with federal affirmative action laws, we must maintain accurate records of the race, sex, disability, and veteran status of applicants and employees.

We request that you complete the information below to assist us in our record-keeping obligations. Please be assured that your voluntary disclosure and any information provided is submitted:

  • On a voluntary basis;
  • On a confidential basis consistent with U.S. Government regulations;
  • For use only in accordance with Executive Order 11246, as amended, the Rehabilitation Act of 1973, and/or the Vietnam Era Veterans Readjustment Assistance Act of 1974, and the regulations issued thereunder;
  • Without subjecting you to any form of adverse treatment.

 

Check applicable box(es) and complete information requested.
Please check ONE box to disclose the race/ethnic origin with which you primarily identify yourself:

Caucasian/White
African-American/Black/Negro
Hispanic/Latino (Spanish/Portuguese/Central or South       American/Mexican/Puerto Rican/Cuban)
Asian (including Pacific Islander)
Native American/American Indian (including Aleutian Islander,       Native Hawai'ian)
Other

Are you:  
A disabled individual? YES    NO
  If "Yes," what is the nature of your disability?
A disabled veteran? YES    NO
  If "Yes," are you entitled to disability compensation under laws administrated by the Veterans Administration for a disability
rated at 30% or more?
YES    NO
  Were you discharged or released from active duty for a disability incurred or aggravated in the line of duty (a "service-connected disability)?
 YES    NO
A Vietnam era veteran? YES    NO
  If "Yes," during what time period were you on active duty?
From   To
  Were you discharged or released because of a "service-connected disability)?
YES    NO
  When were you discharged or released from the armed services?
Your Full Name:

 

 

If you are applying for a truck driver position please click here to continue to the next form.