Personal Information
Email
Name
Social Security #
Address
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Zip Code
Home Phone
Wage Desired
$
Position Applying For
Select Job Title
Mixer
Production Staff
Baker
Counter Associate
job descriptions
How did you hear about job?
Please Select One
Friend
Newspaper Ad
Website
In-Store
Other
Have you ever worked for Breadsmith before?
Yes
No
If yes, give dates and locations:
Do you have the legal right to work in the USA?
Yes
No
Have you ever been convicted of a felony?
Yes
No
If yes, please explain:
Breadsmith is an equal opportunity employer, and therefore
does not discriminate against any employee because of race,
age, color, religion, sex, national origin, ancestry, handicap
or disability, sexual orientation, marital status, off-duty
use of lawful products, membership in the national guard,
state defense force or any reserve component of the military
forces of the United States or your nation of residence, or
any other legal basis. This policy not only to employment,
but to recruitment, recruitment advertising, upgrading, demotion,
transfer, layoff, termination, and other matters pertaining
to personal relationships.
Availability
Employment desired
Full Time
Part Time
Please list specific days and hours available.
Total hours available per week
Any times you are unavailable to work?
Education
HIGH SCHOOL
School Name
Location
Last grade completed
9
10
11
12
Are you currently enrolled?
Yes
No
Have you graduated?
Yes
No
If so, when?
What is/was your GPA?
Please list any scholastic honors, sports or activities.
COLLEGE OR CONTINUING EDUCATION
School Name
Location
Last grade completed
1
2
3
4+
Are you currently enrolled?
Yes
No
Have you graduated?
Yes
No
If so, when?
What is/was your GPA?
Please list any scholastic honors, sports or activities.
Work History
(list most recent job first)
May we contact your present employer?
Yes
No
Company
Location
Phone
Job Title
Please describe your job duties.
Supervisor's Name
Dates worked
from to
Salary
start $ per
hour
year
finish $ per
hour
year
Reason for leaving
Quit
Terminated
Other
Please explain.
JOB #2
Company
Location
Phone
Job Title
Please describe your job duties.
Supervisor's Name
Dates worked
from
to
Salary
start $
per
hour
year
finish $
per
hour
year
Reason for leaving
Quit
Terminated
Other
Please explain.
JOB #3
Company
Location
Phone
Job Title
Please describe your job duties.
Supervisor's Name
Dates worked
from
to
Salary
start $
per
hour
year
finish $
per
hour
year
Reason for leaving
Quit
Terminated
Other
Please explain.
physical requirements
A
manager will describe for you the essential duties of the
job for which you are applying. At that time you may discuss
any accommodations you need to perform those job functions.
1.
I hereby certify that all above questions are fully and correctly
answered. I understand that any misleading or incorrect statements
made as part of this application may be considered cause for
rejection or dismissal. 2. I also grant Breadsmith to establish
my employment eligibility through inquiry of past employment
and education and agree to release from liability all persons
supplying such information. 3. If employed, I agree to conform
to the rules and policies of Breadsmith and that at anytime
I will be free to resign for any reason and that Breadsmith
also holds the same right to terminate my employment at will.
I understand that no representative of Breadsmith other than
the store owner, has the authority to enter into any agreement
for employment for any specified time or to make any agreement
contrary to the foregoing.