Personal Information

    Are you a U.S. citizen?
    Are you authorized to work in the U.S.?
    Have you ever been convicted of a felony?







    Check all days and times that apply.


    Add at least 2 schools.
    + Add School


    Add at least 2 employers.
    + Add Employer


    Add at least 3 personal references.
    + Add Reference
    street (no PO Boxes), City, State & Zip
    Do you currently have a valid driver's license?
    Include State Issued, License No. & Date of Expiration
    Do you have auto insurance?
    Has your auto insurance ever been canceled?
    Have you ever been cited for driving under the influence (DUI) or driving while intoxicated (DWI)?
    Include the date and circumstances
    Have you been cited for any other moving violations in a vehicle during the last five (5) years?
    Include the offense, date of the offense and offense location (county & state). Put each violation on a separate line.
    Have you ever pled guilty or "no contest" or been convicted of a crime?
    Answering "yes" to this question does not constitute automatic bar of employment. Only crimes which are substantially related to the position you are seeking will be considered.
    Have you ever been employed by the Village Market & Caf before?
    Type of employment seeking:
    Are there any days or hours that you cannot work?
    Please list any days and/or hours that you cannot work below. Please explain the reason you are not available during these times or days.
    Do you have any medical or physical conditions which would prevent you from preforming the position which you are seeking?
    May we contact your current employer?
    Include first & last name, relationship & two phone numbers
    Current Physical Address (no PO Boxes), Maiden Name, Former Married Names (or AKAs) and each state lived in past the five (5) years.
    Medical Questionnaire and/or Exam
    I understand that if I receive a conditional job offer and prior to my employment I will be required to complete a Medical Questionnaire and undergo a pre-employment medical examination, drug test, or both. I also understand and agree that a background check will be preformed prior to employment with Green Turtle Bay. I certify that the facts contained in this application are true and complete to the best of my knowledge and belief and understand that if employed falsified statements on this application may result in termination. I authorize investigation of all statements and answers contained in this application for any employment related purpose.

    Additional Application / Interview procedures

    If you are contacted by management of Village Market & Caf to interview for employment additional application paperwork may be required. Please be allow 20 - 25 additional minutes before or after the interview to complete. These must be completed in person by the applicant in the Human Resources office located on Jetty Drive, Grand Rivers, Kentucky 42045.


    Village Market & Caf is an "at-will" and equal opportunity employer.

    I understand that if I am hired, my employment will be for no definite period and that, if hired, my employment is AT-WILL. This means that if hired either the company or I can end the employment relationship at any time without notice and for any or no reason. No person other than the President of Village Market & Caf has the authority to modify this agreement nor make any agreement to the contrary on behalf of Village Market & Caf. Any such modification must be made in writing and signed by the President.

    I understand that Village Market & Caf reserves the right to have me complete a pre-employment medical questionnaire and to require me to submit to a pre-employment medical examination and/or drug test to the extent permitted by law. I authorize Village Market & Caf to investigate my driving record, my criminal record, my credit history, my educational background and my personal references and may interview neighbors and others with whom I am acquainted. This inquiry may include information regarding my character, general reputation, personal characteristics and mode of living.

    I further understand that Village Market & Caf may contact my previous employers and I authorize those employers to disclose to Village Market & Caf all records and other information pertinent to my employment with them.

    I certify that all of the information that I provide in this application for employment and in any interview with company personnel will be true and accurate. I further understand that if I am employed and any such information is later found to be false or misleading in any material respect, I will be dismissed.


    Digital Signature