Employment Application

Work Desired

Position Desired

Location Desired


Please indicate specific times you would be available to work each day:



Employment History:

Please begin with your present or most recent employer.

Employer 1:


Employer 2:


Employer 3:



Reference 1:

This person is a:

Reference 2:

This person is a:

Reference 3:

This person is a:

Reference 4:

This person is a:

Special Skills

, CERTIFY that the above answers are true and complete to the best of my knowledge. I authorize PQM, to investigate any statement contained in this application, and to obtain a credit report on me (and my company if this application is for reselling by a company) as necessary to determine my qualifications. I understand that this application is not and is not intended to be any kind of contract or agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions or interview may result in immediate termination. I understand that I am required to abide by all rules, regulations and policies of PQM.

Mike Oliver
Mike Oliver
Produce Manager
32 Years Service
The Rothwell Family
The Rothwell Family
Mike and Barbara Rothwell Henderson
Charlie Coward
Charlie Coward
Store Manager
29 Years Service
More about our family