AN EQUAL OPPORTUNITY EMPLOYER
The Safeway policy is to provide employment, training, compensation, promotion and other conditions of employment without regard to race, color,
religion, sexual orientation, national origin, sex, age, disability, veteran status, medical condition, marital status or any other legally protected status.
Applicants must reapply at least once every two months to remain under consideration for employment.
First LastMiddle Initial
TEL. NO. ( )
OTHER NAMES USED FOR EMPLOYMENT OR EDUCATION (if any)
Street/Apt. # StateCity CountyZIP
FOR WHAT POSITION(S) ARE YOU APPLYING?
FULL-TIME PART-TIME EITHER
ARE YOU UNDER THE AGE OF 18?
YES NO IF UNDER 18, STATE YOUR AGE
ARE YOU LEGALLY ABLE TO WORK IN THE UNITED STATES?
HAVE YOU WORKED FOR SAFEWAY OR ONE OF ITS AFFILIATED COMPANIES LISTED AT THE TOP OF THIS APPLICATION?
POSITION HELD? REASON FOR LEAVING?
LIST THE NAMES OF RELATIVES EMPLOYED BY ANY OF THE SAFEWAY COMPANIES AND THEIR WORK LOCATION
NAME RELATIONSHIP WORK LOCATION
HAVE YOU BEEN CONVICTED OF A CRIME WITHIN THE LAST TEN (10) YEARS (other than a minor traffic violation)?
*Do not answer YES if the only reason for doing so is either:
(a) If the conviction or plea resulted in a pre-trial or post-trial diversion program; or
(b) If the record of the conviction has been judicially ordered sealed, expunged or statutorily eradicated; or
(c ) If the conviction is a misdemeanor conviction for which probation has been successfully completed or otherwise
discharged and the case has been judicially dismissed pursuant to Penal Code Section 1203.4; or
(d) If the conviction is under California Health & Safety Code sections 11357(b) or (c), 11360(b) (formerly section 11360(c)), 11364,
11365, or 11550, or their statutory predecessors which relate to marijuana convictions that occurred 2 or more years ago.
DATE AVAILABLE FOR WORK TOTAL HOURS AVAILABLE PER WEEK
ou may list time needed for religious practices/observances as “available” time.) The majority of retail store shifts are afternoons, evenings and weekends.
SUN MON TUES WED THURS FRI SAT
HAVE YOU, OR TO YOUR KNOWLEDGE HAS ANY PERSON UNDER YOUR SUPERVISION, EVER BEEN CONVICTED OF A VIOLATION OF CRIMINAL
LAW FOR SELLING OR SUPPLYING TOBACCO PRODUCTS TO A MINOR THAT WAS NOT OVERTURNED ON APPEAL, OR THE RECORD FOR WHICH
WAS NOT JUDICIALLY ORDERED SEALED, EXPUNGED, OR STATUTORILY ERADICATED, OR THE CASE WAS NOT JUDICIALLY DISMISSED PURSUANT
TO CALIFORNIA PENAL CODE SECTION 1203.4, OR WAS NOT RESOLVED BY A REFERRAL TO A PRETRIAL OR POST TRIAL DIVERSION PROGRAM?
IF THE ANSWER TO EITHER OR BOTH QUESTIONS ABOVE IS YES, EXPLAIN THE CIRCUMSTANCES BELOW WITHOUT IDENTIFYING THE NAMES OF
ANY OTHER PERSONS INVOLVED IN THE INCIDENT. (A “Yes” answer will not necessarily disqualify you from employment.)
learn more & join the Safeway team visit Safeway.com
APPLICATION FOR EMPLOYMENT
(California Applicants ONLY)