Hot Bagels and More Application for Employment

Personal Information

First Name (required)

Last Name (required)

Present Address (required)

City (required)

State (required)

Zip (required)

Permanent Address (required)

City (required)

State (required)

Zip (required)

Contact Phone Number (required)

Your Email (required)

Referred By

Employment Desired

Position Desired

Date you can start

Salary Desired(per hour)

Location preference

Preferred Availability
Saturday and Sunday (Mandatory) 
M T W TH F 

Some positions require start times of 4:00am, are you able to work these shifts?

Are you willing and able to lift 30lbs or less?
Yes No 

Are you currently employed
 Yes No

If so, may we inquire of your present employer?
 Yes No

Are you legally authorized to work in the US?
 Yes No

Have you ever worked/applied to this company before?
 Yes No

Which Location?

 Yes No

When?

What's your favorite bagel sandwich?

Education History

High School

Name of High School

High School Address

City

State

Zip

Years Attended

Did you Graduate?
 Yes No

Subjects studied?

College

Name of College

College Address

City

State

Zip

Years Attended

Did you Graduate?
 Yes No

Subjects studied?

Trade/Business School

Name of Trade/Business School

Trade/Business School Address

City

State

Zip

Years Attended

Did you Graduate?
 Yes No

Subjects studied?

General Information

Special Training/Skills

US Military Service?
 Yes No

Rank

Former Employers (Last four employers starting with most recent)

Employer 1

Employer Name

Employer Address

City

State

Zip

Supervisor

Contact Phone Number

Position

Salary

From

To

Reason for leaving

Employer 2

Employer Name

Employer Address

City

State

Zip

Supervisor

Contact Phone Number

Position

Salary

From

To

Reason for leaving

Employer 3

Employer Name

Employer Address

City

State

Zip

Supervisor

Contact Phone Number

Position

Salary

From

To

Reason for leaving

Employer 4

Employer Name

Employer Address

City

State

Zip

Supervisor

Contact Phone Number

Position

Salary

From

To

Reason for leaving

References

List below two individuals, not related to you, whom you have known at least one year.

Reference 1

Name

Address

City

State

Zip

Occupation

Years known

Reference 2

Name

Address

City

State

Zip

Occupation

Years known

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment ad any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) or other relevant federal and state laws."