Employment Application

Applying at Samuels Seafood

The Company uses the following procedures concerning its Employment Application. These procedures are to streamline the application process and to
ensure compliance with various laws and regulations the Company follows in accepting and considering job applications. If you do not follow these procedures, your application will not be considered.

  1. As used in this Application, "Company" refers to Samuels and Son Seafood Co.
  2. The Application must be completed fully. A resume may be attached as a
    supplement, but it is not a substitution for fully, truthfully, and accurately
    completing the Application.
  3. Do not list or identify on the application information that reveals your race, creed, color, national origin, age, religion, disability, or sex. You will be asked to
    voluntarily provide this information in a separate document the Company
    maintains as required by various laws.
  4. Do not provide information that is not specifically requested.
  5. The Company is proud to be an Affirmative Action/Equal Opportunity Employer, M/F/D/V.

NOTICE: This Application is considered active for thirty (30) days from the date submitted. For further consideration after this date, a new application must be submitted.

If other please explain:


Select Location:
PhiladelphiaPittsburghLas VegasOrlando

Job Category:
SalesMarketingAccountingGeneral OfficeWarehouseDriversOther




YesNo If yes, when?  

For whom?  




YesNo If yes, please list  

Note: Answering “Yes” to the following question will not automatically eliminate you from consideration for employment.


If yes, please give date and details of each such termination of employment:



High School

College, Business, Vocational or Other Training

Graduate/ Professional


If yes, please give the date you were first unemployed  


Please list the names of your present or previous employers in chronological order with present or last employer listed first. Be sure to account for all periods of time including any military service and any period of unemployment. If self-employed, give firm name and supply business references, and, if necessary, request a continuation page to fully and accurately complete this section.

Employer 1

Employer 2

Employer 3

Employer 4

Professional References (No personal references please)


Complete if applicable to the position for which you are applying:

Clerical Applicants

Driving Applicants

(A separate driver’s qualification application must be completed)




Your driving record will be checked if you drive a company vehicle.


List Driver's License Information

Give State, Year and Number (if known) of all other Licenses held in the last seven years:

Accident Record For Last Three Years


I hereby certify that this application (and accompanying resume, if any) is true and complete, contains no willful misrepresentation or falsification, and that the information given by me is true and accurate. I understand that findings of any misrepresentation, falsification, or omission could result in the rejection of my application or in the immediate termination of my employment.

I authorize all previous and current employers, or anyone identified as a reference, to give any and all information concerning my employment history to the Company, and I release all parties of any and all liabilities from any damage, which may result from the furnishing of such information.

If I am hired, I understand that my employment will be for no definite period of time, regardless of the period of payment of my wages. I further understand I have the right to terminate my employment at any time, with or without notice, and that the Company has the same right. I agree that the contents of employee
handbooks, personnel manuals, benefit plans, policy statements, and the like, as they may exist from time to time, shall not serve as such writing to modify the at will nature of my employment. No one other than the CEO, COO or the CFO, of the Company has the authority to modify the at will nature of the employment
relationship or make any agreement to the contrary. Any such modification must be in writing.

I agree to submit to any physical examination and/or lawful drug and alcohol integrity testing that may be required as a post-offer condition of employment. I
understand that any offer of employment will be contingent upon successful results of a drug screen, physical examination, or background investigation, if

I certify and agree to the above.


Confidential and Voluntary

Samuels and Son Seafood Co. are committed to an Affirmative Action Program which includes giving full consideration for employment to qualified individuals without regard to race, color, religion, gender or national origin. The following information is being requested of all applicants for employment. You’re providing this information is strictly voluntary. The self-identification request is made in compliance with the regulations issued by the U.S. Department of Labor. Responses will be used for the purpose set forth in these regulations. Its purpose is to assist Samuels and Son Seafood Co. in monitoring its Affirmative Action Program and to aid in complying with required Governmental record keeping and periodic reporting. A copy of the AAP is available during normal business hours (call your local personnel office).

This information is not part of the employment application. It will be processed separately and will not be considered in the employment/selection process. If you choose to provide information, please complete the following:


RACE/ETHNICITY (check one):

American Indian or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteHispanic or LatinoTwo or more races

* To comply with OFCCP regulations, a visual observation may be made to gather the above demographic data.