Job Application

Personal Information

First Name
Last Name
Address
City
State
Zip
Phone
Email

Wage Desired
Position Applying For
How did you hear about job?
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.

Education

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

Job 1

(List most recent job first)
May we contact your present employer?
 Yes No
Company
Location
Phone
Job Title
Supervisor's Name
Please describe your job duties.
Dates Worked to
Salary
Start $ per
Finish $ per
Reason for leaving
 Quit Terminated Other
Please explain

Job 2

Company
Location
Phone
Job Title
Supervisor's Name
Please describe your job duties.
Dates Worked to
Salary
Start $ per
Finish $ per
Reason for leaving
 Quit Terminated Other
Please explain

Job 3

Company
Location
Phone
Job Title
Supervisor's Name
Please describe your job duties.
Dates Worked to
Salary
Start $ per
Finish $ per
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.
Completed by
Date