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Employment

Requested Information
Position(s) applied for
How did you find out about this job?
Why are you seeking a new job at this time?
5. Have you been convicted of a crime? (Massachusetts applicants should not include misdemeanor convictions; California applicants should not include marijuana-related convictions that occurred more than 2 years prior to the application date.)

Applicant Information
First Name
Middle Name
Last Name
Street Address
Social Security No.
City/State/Zip
Date of Birth
Home Phone
Cell Phone
1. If hired, do you have a reliable means of transportation to get to work? Describe
2. Are you at least 18 years old?
If you are under 18 years of age, can you furnish a work permit?
3. Driver’s License No.
State
Expiration Date
4. Are you legally eligible for employment in the U.S.? (Proof of U.S. citizenship or immigration status is required if hired.)
if yes, state the nature of the offense and disposition of the case. Include dates and places. (NOTE: The existence of a criminal record does not constitute an automatic bar to employment.)
6. Are you a veteran?
If yes, give dates of service: From-To
7. List any special skills or training:

Employment Information
8. Are you seeking:
9. What hours and shift(s) would you prefer to work?
10. List times you are not available to work?
11. Are you willing to work:
12. Are you currently employed?
If yes do you intend to keep your present job
13. If hired, when would you be able to start?
14. Have you ever worked for this organization before?
If yes, name used:
15. We may conduct training or meetings on days, or at times, you have other obligations. Is your schedule flexible so you may come to training
16. Are you, or do you plan to be in school or taking courses at any time while working here
17. If you have other obligations or commitments that may affect your schedule (such as travel plans) please indicate the particular dates and times that you will be unavailable
18. How many jobs have you held in the last two years
19. List any friends or relatives employed by this company:
20. Have you ever been discharged or asked to resign from any position?
If yes, please describe:
21. Can you perform the essential functions required by the job for which you are applying either with or without reasonable accommodations?
22. If the answer is no, please describe which tasks, if any, you will need accommodation to perform, and explain what type of accommodation you will need:
23. Do you agree not to bring into Baker’s Restaurant confidential information of any third parties that relates in any way to the restaurant industry, and to keep confidential and not disclose any of Baker’s Restaurant’s or any third parties confidential information?

Education
Highschool:
Name of School
College
Name of College
If in high school, are you enrolled in a recognized co-op program?
Degree & Major
If yes, identify program and school:
Minor

Work History (please begin with most recent)
1. Company

Work History (please begin with most recent)
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From -To
Salary: Beginning
Salary: Ending
Job Title
Supervisor’s Name & Title
Describe duties briefly:
Specific reason for leaving:
2. Company
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From - To
Salary: Beginning
Salary: Ending
Job Title
Supervisor’s Name & Title
Describe duties briefly:
Specific reason for leaving:
3. Company
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From - To
Salary: Beginning
Salary: Ending
Job Title
Supervisor’s Name & Title
Describe duties briefly:
Specific reason for leaving:
Have you attended any of the above Schools or Employment under a different name?
If so, What Name?
May we contact the above references to verify employment?
If not, specifically describe why?
 

Additional Information: