Option #1 Position Applying For: _____________________________ Option #2 Position Applying For: _____________________________
List skills relevant to the position(s) you are applying for: ______________________________________________________________________________
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What type of employment are you looking for? |
Full Time or |
Part Time |
Are you currently employed? |
Yes No |
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May we contact your current employer? |
Yes |
No |
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If hired do you intend to keep your present job? Yes |
No |
Specify hours available for each day of the week (if available anytime write ANY): |
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Monday |
Tuesday |
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Wednesday |
Thursday |
Friday |
Saturday |
Sunday |
Have you ever worked for Vallarta Supermarkets before? Yes |
No If “yes,” give dates From ____/____/___ To ___/___/___ Location: _______________ |
Reason for leaving Vallarta Supermarkets? _________________________________________________________________________________________
Are you able to perform the essential functions of the job for which you are applying, either with or without a reasonable accommodation? 
Yes 
No If “no, describe the functions that cannot be performed. __________________________________________________________________________________
(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)
WORKING SAFELY IS A CONDITION OF EMPLOYMENT
Vallarta Supermarkets is committed to providing a safe, healthy and secure work environment for our team members and customers through
our Work Safe programs. We achieve our Work Safe goals through partnership with our team members, managers and leadership. Vallarta Supermarket’s Work Safe programs are based upon the following principles:
Work Injuries and illnesses are preventable and we have a clear goal to achieve zero injuries.
Safety is everyone’s responsibility
Working safely is a condition of employment
Compliance with all applicable health and safety requirements is paramount.
The integrity of our Work Safe programs is ensured through sensible hiring, and comprehensive ongoing safety training that begins on every team member’s first day. At Vallarta Supermarkets, our work is never too urgent or too important so that we cannot take the time
to do it safely.
Vallarta is an equal opportunity employer. Vallarta provides equal employment opportunity for all applicants and prohibits discrimination based on race, color, sex (including pregnancy, childbirth, breastfeeding and medical conditions related to pregnancy, childbirth, or breastfeeding), gender, religious creed (including religious dress and grooming practices), marital status, domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic information and characteristics, sexual orientation, gender identity or expression, military or veteran status, or any other basis protected under federal, state, or local laws.
Vallarta will make reasonable accommodations, where appropriate, to assist applicants with disabilities with Vallarta’s application and hiring processes, if the accommodation does not result in an undue hardship to the Company or a direct threat to health and safety.