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Employment

Click here to download and print a paper copy. Please hand into store when complete!

  • Applicant Information

  • (###)###-####
  • (be specific - max 3)
  • MM slash DD slash YYYY
  • Availability

    List approximate times available next to each day. (ex. Monday: 3pm to 10pm)
  • Education

  • References

  • Employment History

    Please list all present and past employers. Begin with your most recent.
  • Please enter salary range. Starting and end salary.
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • Please enter salary range. Starting and end salary.
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • Please enter salary range. Starting and end salary.
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • MM slash DD slash YYYY
    MM/DD/YYYY
  • Military Service

  • Disclaimer and Signature

    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.
  • MM slash DD slash YYYY

Costa's Supermarket
407 E. Water St.
Smethport, PA 16749

Monday through Saturday: 7am - 9pm
Sunday: 8am - 9pm
Thanksgiving: 7am - 1pm
CLOSED - Christmas Day & Easter Sunday

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