Employment Application Applicant InformationStore(Required)Select your Woodman's StoreAppletonAltoonaBeloitBuffalo GroveBloomingdaleCarpentersvilleGreen BayJanesvilleLakemoorKenoshaMadison (East)Madison (West)Menomonee FallsOak CreekOnalaskaNorth AuroraRockfordSun PrairieWaukeshaName(Required) First Last Email(Required) Phone(Required)Position(s) Applying For(Required) Add Remove(be specific – max 3)Date Available(Required) MM slash DD slash YYYY Current Street Address(Required) Current City(Required) Current State and Zip Code(Required) Select Your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address same as Current Address(Required) Yes No Mailing Street Address(Required) Mailing City(Required) Mailing State and Zip Code(Required) Select Your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Provide any different names you have utilized since age 18 What shift are you available to work:(Required) 1st or 2nd Shift Full-Time 3rd Shift Full-Time Nights and Weekends Weekends Only Other Explain Other Availability:(Required) Preferred Weekday Start Time:(Required) Do You Have a Reliable Source of Transportation To And From Work?(Required) Yes No Do You Have A Valid Drivers License? (Applicable only for certain positions)(Required) Yes No Are You At Least 18 Years Of Age?(Required) Yes No Are You Under 16 Years Of Age?(Required) Yes No Are You Legally Eligible To Work In The United States?(Required) Yes No The essential function of most jobs at Woodman's will require that employees lift up to 50 lbs. frequently, bend and stoop frequently, push carts frequently, stand and/or walk for long periods of time, some climbing, and work in extreme temperatures. To the extent these function may be applicable to the position for which you are applying, can you perform all of the above functions with reasonable accomodation?(Required) Yes No Answering “NO” to this inquiry is not an automatic bar to employment. Woodman’s is an equal opportunity employer and complies with all facets of the American with Disabilities Act (and any applicable state laws).Have you served in the military?(Required) Yes No Where you honorably discharged?(Required) Yes No Branch:(Required) Years:(Required) Rank At Discharge:(Required) EducationHighest Grade of Year Completed In School(Required)Select Year123456789101112High School Diploma or GED?(Required) Yes No High School Name:(Required) Location:(Required) Training Beyond High School (College, University or Other Schools)(Required) Yes No School Name:(Required) Location:(Required) Major Field:(Required) Years Attended:(Required) Credits Earned: GPA/Basis: Degree Earned:(Required) Describe any other education or training which you feel is relevant to the jobs(s) for which are you are applying. Also include relevant licenses and certifications. Be Specific.Work ExperienceProvide a description of all jobs. Be specific. Start with you most recent job. For part-time work, show the average number of hours worked per week. Indicate any change in job title with the same employer as a separate job.Number of Previous Jobs(Required) None One Two Three Job 1Employer: Type of Business: Street: City: State and Zip Code Select Your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title: Reason For Leaving: Employment StatusFull-TimePart-TimeName of Supervisor: Job Duties: From (Month & Year): To (Month & Year): Job 2Employer: Type of Business: Street: City: State and Zip Code Select Your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title: Reason For Leaving: Employment StatusFull-TimePart-TimeName of Supervisor: Job Duties: From (Month & Year): To (Month & Year): Job 3Employer: Type of Business: Street: City: State and Zip Code Select Your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title: Reason For Leaving: Employment StatusFull-TimePart-TimeName of Supervisor: Job Duties: From (Month & Year): To (Month & Year): May we communicate with your present employer?(Required) Yes No May we communicate with your former employer?(Required) Yes No Have you done any volunteer work?(Required) Yes No Please describe your volunteer work:(Required)Have you worked for Woodman's before?(Required) Yes No Which store?(Required) What years?(Required) ReferencesList up to three references other than former employers or relatives.Name: Address: Phone:Name: Address: Phone:Name: Address: Phone:Disclaimer and SignatureBY MY SIGNATURE BELOW, I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACTS ON THIS APPLICATIONS (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of Woodman’s to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, sexual orientation, or pregnancy, and to afford equal opportunities to disabled veterans, individuals with a disability, and any other characteristics protected by federal, state or local laws. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release Woodman’s from all liability that might result from making an investigation. I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.Applicant Signature(Required) (Type Name)How did you hear about our job opening? Social Media In-Store sign In-Store Announcement Job Fair Semi Trailer Employee Referral Employment Website Other Employee Name Site Name Please Describe "Other" CAPTCHA