Your Name
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First Name
Last Name
Your Email Address
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Your Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Your Phone Number
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(###)
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####
Your Birth Date
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MM
DD
YYYY
Position(s) You're Applying For
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Are you ServSafe certified?
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What is your availability?
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Please list the days of the week and times you're available to work.
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What date are you available to start work?
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MM
DD
YYYY
Are you currently enrolled in school?
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If you are currently in school, where do you attend?
High School Years Completed
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College Years Completed
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College Major (if applicable)
Do you have a college degree?
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Where were you most recently employed?
What was your position?
What were the start and end dates of your employment?
What was your reason for leaving?
Please list your supervisor's name and phone number.
Please list your starting wage and end wage.
Where were you employed prior to the job you entered above?
What was your position in that job?
What were the start and end dates of your employment?
What was your reason for leaving that job?
Please list your supervisor's name and phone number.
Please list your starting wage and end wage.
Reference 1: Please provide the name of a personal reference, along with the nature of your relationship with them.
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Reference 1: Please provide a phone number for the reference you listed above.
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Reference 2: Please provide the name of another personal reference, along with the nature of your relationship with them.
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Reference 2: Please provide a phone number for the reference you listed above.
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Please list any skills or training that would be beneficial to the position for which you're applying.
Heirloom Bakery & Hearth is a non-smoking business. We do not allow smoke breaks during work shifts. Can you work under these conditions?
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This is an active job where you will be spending long periods of time on your feet. In addition, you will need to be able to lift 25 lbs. Are you able to work under these conditions?
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If you answered "no" to the previous question, please explain.
By checking the box below, I authorize Heirloom Bakery & Hearth to contact references and previous employers. I understand that falsification of information could result in exclusion from employment consideration. Furthermore, I understand that if employed, the employment relationship may be terminated by the employer at will (or without reason) and that this relationship may not be changed without a written contract. I understand that I am not guaranteed a minimum number of hours worked per week. Finally, I understand that all baking formulations and processes are proprietary information (or trade secrets) and will be treated as such. Accordingly, such information may not be disclosed to anyone or used by the employee (not in connection with Heirloom Bakery & Hearth) for his or her own gain, directly or indirectly. I also understand that the workplace is subject to video surveillance.
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