Groove Employment Application

Full Name*

First NameMiddle NameLast Name

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Email Address*

Store Location Applying To*

Position Applying For

What Languages Do You Speak Fluently:

EnglishSpanish

How Soon Can You Start?*

MonthDayYear

Availability*

Desired Wage

Are You a Citizen of the United States?*

YesNo - but authorized to work in the U.S.No - not authorized to work in the U.S.

Have You Ever Worked For This Company?*

Have you ever been convicted of a felony?*

High School

High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

High School From

Date

High School To

Date

Did You Graduate?

College

College Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

College From

Date

College To

Date

Did You Graduate?

Reference #1 Name*

First NameLast Name

Relationship*

Company

Phone Number*

Area CodePhone Number

Reference #2 Name*

First NameLast Name

Relationship*

Company

Phone Number*

Area CodePhone Number

Reference #3 Name*

First NameLast Name

Relationship*

Company

Phone Number*

Area CodePhone Number

Company*

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor*

Job Title*

Starting Salary*

Ending Salary*

Responsibilities*

Start Date*

Date

End Date*

Date

Reason for Leaving*

May we contact your previous supervisor for a reference?*

YesNo

Company*

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor*

Job Title*

Starting Salary*

Ending Salary*

Responsibilities*

Start Date*

Date

End Date*

Date

Reason for Leaving*

May we contact your previous supervisor for a reference?*

YesNo

Company*

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor*

Job Title*

Starting Salary*

Ending Salary*

Responsibilities*

Start Date*

Date

End Date*

Date

Reason for Leaving*

May we contact your previous supervisor for a reference?*

YesNo

Branch

From

Date

To

Date

Discharge Rank

Discharge Type

If other than honorable, explain

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature*

Signature Date*

Date

(Optional) Upload Resume

Upload a File

Groove Employment Application

APPLICATION INFORMATION

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

MILITARY SERVICE

DISCLAIMER AND SIGNATURE