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Please notify the Human Resources Department if you need help in completing this application (see bottom of this page for contact info).
Busch's - Online Employment Application
Positions applying for 
Store(s) interested in
Ann Arbor (Green Rd)
Ann Arbor (Main St.)
Carlton
Clinton
Dexter
Farmington Hills
Livonia
Novi
Pinckney
Plymouth
Rochester Hills
Saline
South Lyon
Tecumseh
West Bloomfield
Production Center/Clinton, MI
Corporate office
Referral source (required)
Other referral source (if not listed above)

Personal information
Name 
Address 1 
Address 2 
City   State  Zip
Email address 
Home phone 
Work phone 
   May we contact you at work? 
Cell phone 
Are you 16 or older?  Are you 18 or older? 

High school information
School name 
Location 
Last year completed  Did you graduate? 
College information
School name 
Location 
Last year completed  Did you graduate? 
Major/Minor 
Degree 
Other education
specify type 
School name 
Location 
Last year completed  Did you graduate? 
Study course 
Degree 

Employment information
Are you willing to work full-time or part-time? 
full-time part-time
Available hours per week? 
Specify days and hours available 
Expected rate of pay 
Were you previously employed by Busch's? 
If yes, when? 
List any relatives working for Busch's 
What date are you available to start work? 
Have you ever been convicted of any crime? (Note: A conviction will not necessarily disqualify you for consideration of employment)
If yes, please explain 
Are there any other experiences,
skills or qualifications which you feel
would especially fit you
for work with Buschs's?
Are you legally eligible to work in the US? 

Employment history information
Please list present and past employers beginning with the most recent, including volunteer activities.
Job 1
Company name 
Address 1 
Address 2 
City   State  Zip
Phone 
Type of business 
Supervisor name 
May we contact company for a reference? 
Start date (mm/yy) 
    End date (mm/yy) 
Starting salary 
    Ending salary 
Reason for leaving 
Job title/ Description 
Job 2
Company name 
Address 1 
Address 2 
City   State  Zip
Phone 
Type of business 
Supervisor name 
May we contact company for a reference? 
Start date (mm/yy) 
    End date (mm/yy) 
Starting salary 
    Ending salary 
Reason for leaving 
Job title/ Description 
Job 3
Company name 
Address 1 
Address 2 
City   State  Zip
Phone 
Type of business 
Supervisor name 
May we contact company for a reference? 
Start date (mm/yy) 
    End date (mm/yy) 
Starting salary 
    Ending salary 
Reason for leaving 
Job title/ Description 
Job 4
Company name 
Address 1 
Address 2 
City   State  Zip
Phone 
Type of business 
Supervisor name 
May we contact company for a reference? 
Start date (mm/yy) 
    End date (mm/yy) 
Starting salary 
    Ending salary 
Reason for leaving 
Job title/ Description 

The Predictive Index
DIRECTIONS: Please read the words in the list below and check those that you feel describe the way you are expected to act by others.
Helpful
Relaxed
Exciting
Assertive
Patient
Conscientious
Sophisticated
Persistent
Earnest
Outstanding
Sympathetic
Loyal
Self-Starter
Conventional
Eloquent
Cynical
Passive
Gentle
Brave
Appealing
Thoughtful
Self-assured
Steady
Competitive
Fashionable
Neat
Audacious
Polished
Fearful
Esteemed
Worrying
Sentimental
Adventurous
Easy Going
Unassuming
Good Mixer
Agreeable
Well-Liked
Docile
Demanding
Charitable
Persuasive
Careful
Satisfied
Understanding
Spirited
Congenial
Obedient
Cheerful
Obstinate
Convincing
Responsive
Neighborly
Selfish
Reserved
Serious
Persevering
Calm
Popular
Polite
Dynamic
Good-Humored
Escapist
Generous
Unobtrusive
Daring
Tolerant
Nice
Compelling
Resolute
Tranquil
Cultured
Dominant
Respectful
Nonchalant
Flexible
Attractive
Trusting
Eager
Shy
Fussy
Versatile
Amiable
Diplomatic
Self centered
Consistent
 
DIRECTIONS: Continue by reading the words in the list below, now checking those that you yourself believe really describe you.
Helpful
Relaxed
Exciting
Assertive
Patient
Conscientious
Sophisticated
Persistent
Earnest
Outstanding
Sympathetic
Loyal
Self-Starter
Conventional
Eloquent
Cynical
Passive
Gentle
Brave
Appealing
Thoughtful
Self-assured
Steady
Competitive
Fashionable
Neat
Audacious
Polished
Fearful
Esteemed
Worrying
Sentimental
Adventurous
Easy Going
Unassuming
Good Mixer
Agreeable
Well-Liked
Docile
Demanding
Charitable
Persuasive
Careful
Satisfied
Understanding
Spirited
Congenial
Obedient
Cheerful
Obstinate
Convincing
Responsive
Neighborly
Selfish
Reserved
Serious
Persevering
Calm
Popular
Polite
Dynamic
Good-Humored
Escapist
Generous
Unobtrusive
Daring
Tolerant
Nice
Compelling
Resolute
Tranquil
Cultured
Dominant
Respectful
Nonchalant
Flexible
Attractive
Trusting
Eager
Shy
Fussy
Versatile
Amiable
Diplomatic
Self centered
Consistent
 
Copyright 1955, 1963, 1968, 1992 by Arnold S. Daniels. All rights reserved. No part of this form may be reproduced by any means, nor transmitted, nor translated into a machine language without the written permission of the publisher.

* I understand to be employed I must be lawfully authorized to work in the United States and I must show the employer documents that prove this.

* I understand Busch's may thoroughly investigate my work and personal history and verify all data given on this application, on related papers and in interviews. I authorize all individuals, except those noted, to provide any information requested about me.

* The information in this application (and accompanying documents, if any) is true and complete to the best of my knowledge. I affirm I have a genuine intent and no other purpose in applying for a job with Busch's. I agree and understand that any misrepresentation of information, or failure to disclose information during the employment process, may disqualify me from further consideration for employment and, if employed, will be just cause for termination, regardless of when it was discovered.

* I may be required to submit to a pre-employment drug test. I understand that refusing or failure to submit to such a test, the falsification of a test or a positive test result will remove me from consideration for employment.

* Under Michigan law, I understand Busch's must be notified, in writing, for a request of accommodation within 182 days of the date I know that an accommodation is needed. Failure to properly notify Busch's Director of Human Resources will preclude any claim that Busch's failed to accommodate the disability.

* This employment application will become inactive after 60 days. If I wish to be considered after that time, I must complete a new application.

* If hired, I agree that any and all claims arising out of or relating in any way, in whole or in part, to my hiring, employment or termination, excluding only claims covered by worker's compensation laws, that are not resolved through Busch's open door policy, including but not limited to claims arising under state or federal civil rights statutes, must be decided by binding arbitration. This does not affect the right of the EEOC or any other governmental enforcement agency not a party to this, to bring a court action on my behalf. The demand for arbitration must be made to Busch's within 180 days of the date upon which your claim is presented to the department manager or in case of termination, within 180 days of the date of termination. I waive any limitation periods to the contrary.


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Please send your resume to:

Busch's, Inc.
Human Resources
565 E. Michigan Ave.
Saline, MI 48176
Fax (734) 214-8334
Voice Mail: (734) 214-8324
Email: jobs@buschs.com