PERSONAL INFORMATION
Name:
Date:
Email:
Phone:
Address:
I am 18 or Older: Yes No
If No my birthday is:
EMPLOYMENT DESIRED
Please indicate the stores you would be willing to work at: (may choose multiple)
Christiana, DE Glen Mills, PA Greenville, DE Pike Creek, DE Wilmington, DE
Position Desired:
Date Available:
Currently Employed: Yes No
May We Contact: Yes No
Phone:
Have you applied to purebread before: Yes No
If "Yes" when and where:
If "Yes" what was your reason for leaving:
Preferred number of shifts:
Part-Time: Yes No Full-Time: Yes No Over-Time: Yes No
SCHEDULE OF AVAILABILITY
CITIZENSHIP
The U.S. Government requires that all persons hired after November 6, 1986 must:
(1) show the employer original documents which establish identity and work authorization, and
(2) complete and sign a form claiming they are eligible to work in the U.S. Examples of acceptable documents (which must be presented upon employment) include:
Identity
- State-issued identification card or driver's license
- School identification card with photo
- If hired, can you provide proof that you have the
Work Authorization
- Social Security Card
- Certificate of birth in U.S.
- Alien Registration Receipt Card
right to work in the United States? Yes No
WORK HISTORY
Past Employment -1
Name and Location:
Position:
Dates:
Salary:
Reason for Leaving :
Past Employment -2
Name and Location:
Position:
Dates:
Salary:
Reason for Leaving :
Past Employment -3
Name and Location:
Position:
Dates:
Salary:
Reason for Leaving :
EDUCATION
OTHER
Have you ever been convicted or plead guilty to a crime? (excluding traffic violations or misdemeanors) Yes No
If yes, describe in full:
GENERAL
What additional relevant experiences or training have you had other than your work experience, military service, or education?
ACTIVITY
Civic, athletic, fraternal, etc.(Exclude organizations which indicate race, religion, color, or national origin of members)
Acknowledgment of Truthfulness of Application
I understand that PureBread Deli has a right to rely upon the truthfulness of all statements in the Employment Application.
If I am later hired and any statement on this Employment Application is at any time found to be untrue, PureBread Deli retains the right to terminate my employment. I further understand that if I am hired, I will be an "Employee at Will" This means I am free to terminate my employment at any time for any reason with or without cause and PureBread Deli Management retains the same right.
I have read all terms and conditions
