Application for Employment

Our Slatersville location has a job opening for a part time baker. Must have supermarket baking experience and available for mornings and weekends. Please call Kim Winnard the Store Director for more information at 762-1020.

	Applicant Information
First Name	*
Last Name	*
Address	*
City	*
State	*
Phone	*
Email	*
Desired Salary
Position Applied For	*

Are you a citizen of the United Sates?
If no, are you authorized to work in the U.S.?
Have you ever worked for this company?
If so, when?
Have you ever been convicted of a felony?
If yes Explain.

	Education
High School		Address
From	To	Degree
Did you graduate?
College		Address
From	To	Degree
Did you graduate?
Other		Address
From	To	Degree
Did you graduate?

	References
	Please List three Professional References
Full Name		Relationship
Company		Phone
Address

Full Name		Relationship
Company		Phone
Address

Full Name		Relationship
Company		Phone
Address

	Previous Employment
Company		Phone
Address		Supervisor
Job Title		From	To
Starting Salary
Ending Salary
Responsibilities
Reason for Leaving:
May we contact previous supervisor

Company		Phone
Address		Supervisor
Job Title		From	To
Starting Salary
Ending Salary
Responsibilities
Reason for Leaving:
May we contact previous supervisor

Company		Phone
Address		Supervisor
Job Title		From	To
Starting Salary
Ending Salary
Responsibilities
Reason for Leaving:
May we contact previous supervisor

	Military Service
Branch		From	To
Type of Discharge		Rank at Discharge
If other than honorable, Explain

	Disclamer
	I certify that my answers are true and complete to the best of my knowledge
	If this application leads to employment, I understand that false or misleading information in my application or interview may result in release