Employment Application - Bakers Quality

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Social Security Number

Phone*

Email*

Are you 18 years of age or older?*

Yes
No

Type of position you are applying for:*

What machinery or office equipment are you qualified to use?

Are you legally authorized to work in the United States?*

Proof of your identity and work authorization will be required upon employment.

Yes
No

High School Education*

Name of School	Number of years attended	City	Did you Graduate

Other Education

Name of School	Number of years attended	City	Course/Major	Did you Graduate

Work Experience*

Company Name	Address	Start Date	End Date	List Duties	Wage at Start	Wage at End	Reason for Leaving

Emergency Contacts*

Name	Address	Phone Number	Occupation

Have you been convicted of a felony or misdemeanor within the last 5 years?*

You will not be denied employment solely because of a conviction record unless the offense is substantially related to the position for which you have applied.

Yes
No

Describe*

Applicant's Certification, Authorization, and Release Statement

I certify that the information provided by me in this application and given during the interview process, whether orally or in writing, is true and complete to the best of my knowledge and belief. I understand and agree that any omission or misrepresentation of fact, as stated or implied, may result in the denial of employment or in termination if I am hired and that Baker's Quality Pizza Crusts, Inc. (the Company) shall not be held liable in any respect if my employment is terminated for that reason.

I understand and agree that all information furnished in this application may be verified by the Company or its authorized representative and I authorize the Company to do so. I waive any right I may have to notice from any individuals and organizations named or referred to in this application prior to the release of any employment information to the Company. I hereby authorize all individuals and organizations named or referred to in this application and any law enforcement organizations, to give the Company all information relative to such verification and hereby release and hold harmless such individuals, organizations and the Company from any and all liability for any claim or damage resulting therefrom.

I understand that, if I am hired, I am required to abide by all rules, policies, and procedures of the Company. I also understand that the Company's rules, policies, and procedures are subject to modification without notice to me.

I also understand that the Company is not obligated to provide employment and that I am not obligated to accept employment. Nothing in this application or in any prior oral or written statements is intended to create a contract of employment. If I am hired by the Company, I understand that my employment will at all times be at-will, and for no definite period, and that either I or the Company may end the employment relationship at any time without notice or cause. I understand that only the Company President has the authority to enter into any agreement contrary to the foregoing. Any such agreement with the President must be in writing and signed by the President of the Company.

I understand that this application form will be considered current for only sixty (60) days and that I will need to complete a new application form if I wish to be considered for employment beyond that period.

I have read and understood the above.

Enter Name