Apply Your Name (required) Address City State Zip Are you 16 or older? YesNo Who referred you to Upcountry Provisions (optional)? Your Email (required) Your Telephone Number (required) Type of Work Desired (can check more than one): Full Time (32 hours+)Part Time (5-31 hours)SeasonalTemporary Work Schedule Availability (check all that apply): Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PM Professional Reference #1 (Name and Contact Info)- Professional Reference #2 (Name and Contact Info)- Most Recent Employer (Business, Manager Name, Phone Number)- Job Details (Dates of Employment, Job Title, Rate of Pay) Previous Employer (Business, Manager Name, Phone Number)- Job Details (Dates of Employment, Job Title, Rate of Pay) Have you ever been convicted of a crime? YesNo If yes, please explain: Please select the days you are available for an interview: MondayTuesdayWednesdayThursdayFridaySaturdaySunday Emergency Contact Name and Phone Number Upload a resume (doc, docx, pdf, jpg): I understand that if selected I would be participating in a “working interview” and that I am working at my own risk. If an incident occurs, I am responsible for all injuries and damages and not Upcountry Provisions. No pay will be given for this “working interview." During this interview, I could be asked to do a set of tasks that Upcountry Provisions does routinely. A Stage interview is a test and not training. By selecting this box, I verify that I have read and agree to the above terms and conditions listed in the description of the Stage Interview. By selecting this box, I agree to a criminal background check By selecting this box, I agree to drug screening By selecting this box, I state that I am legally eligible for employment within the U.S. (all new hires will be required to provide proof of eligibility). By selecting this box, I verify that the above stated information is true and complete Thank you for taking the time to fill out this application. We will contact you in the event of an opening to schedule a stage interview.