Application for Employment s39

Application for Employment

Better Baked Foods of Erie LLC 2200 East 38th Street Erie, PA 16510

PLEASE READ CAREFULLY – PRINT CLEARLY – ANSWER ALL QUESTIONS

COMPLETION OF THIS FORM WILL ASSIST IN THE EVALUATION OF YOUR ABILITY AND POSSIBILITY OF SUCCESS IN THE POSITION FOR WHICH YOU ARE APPLYING. RECEIPT OF THIS APPLICATION DOES NOT IMPLY THAT THE APPLICANT WILL BE EMPLOYED. EVERY EFFORT HAS BEEN MADE TO COMPLY WITH THE APPLICABLE FEDERAL AND STATE LAWS. IT IS NOT OUR INTENT TO DISCRIMINATE IN EMPLOYMENT ON ACCOUNT OF COLOR, SEX, RELIGION, AGE, NATIONAL ORIGIN, DISABILITY, VETERAN STATUS, SEXUAL ORIENTATION, MARITAL STATUS OR ANY OTHER LEGALLY PROTECTED STATUS.

BETTER BAKED FOODS OF ERIE PARTICIPATES IN E-VERIFY TO VERIFY IDENTITY AND WORK ELIGIBLITY.

* This application will be considered only for employment purposes by the company for a period of six (6) months from this application’s date after which a new application must be completed and filed.

Please answer all questions completely. If employed, this completed application will become part of your permanent record.

Date of Application ______Position(s) Applied For ______

Referral Source: Advertisement Current Employee Walk in Employment Agency Friend Other ______

Name______LAST FIRST MIDDLE

Address______NUMBER STREET CITY STATE ZIP CODE

Phone No. (______)______Alternate Phone No. (______)______AREA CODE AREA CODE E-Mail Address: ______

Other name(s) you have been known by on your academic or employment records and date(s) of use:______

______

Have you filed an application here before? Yes No Date______

Have you ever been employed here before? Yes No Date______Are you available to work? 1st Shift 2nd Shift 3rd Shift Weekends Full time Are you on lay-off and subject to recall? Yes No Have you ever been discharged (fired) or asked to resign from a job: Yes No If yes, explain ______Are you over the age of 18? Yes No Do any of your friends or relatives, other than your spouse, work here? Yes No If yes, list name(s)______

Have you ever been convicted of a felony? Yes No Note: This question does not apply to convictions which have been expunged, sealed, pardoned, or otherwise exonerated or eradicated. (A conviction record will not necessarily be a bar to employment. A conviction which is substantially related to the functions or qualifications of the position for which you are applying may be taken into consideration.) If yes, please describe fully the criminal conviction(s), listing the nature of the offense(s) and your rehabilitation since the conviction(s)______

______Are you legally qualified to work in the United States? Yes No

**Proof of citizenship or immigration status will be required upon employment.

Have you ever had any job-related training in the United States military? Yes No

If yes, please give dates and explanation______

______

Are you able to perform all of the essential functions Yes No of the position for which you are applying?

If no, are there reasonable accommodations that can be made to allow you to perform the essential requirements of the job?______

______

List professional, trade, business or civic activities and offices held. (You may exclude memberships which indicate race, color, religion, sex, national origin, disability or other protected status.) ______

______

References (Please list three people who are not related to you or previous supervisors who can provide references.)

Name Address Phone # Relationship Occupation Years Known

Education

# of Years Name & Location of School Course of Study or Major Completed Diploma/Degree

Elementary Yes / No

High School Yes / No

College Yes / No

Graduate Yes / No

Vocational Yes / No

If you do not have a high school diploma, do you have a GED? Yes No Can you provide a copy? Yes No Employment History

List each job held. Start with your present or last job. Account for all periods of time, including unemployment and military service.

Dates Hourly Rates/Salary Employer From To Starting Final Name

Address Work Performed

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving Dates Hourly Rates/Salary Employer From To Starting Final Name

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving

Job Title

Supervisor

Reason for Leaving

If you need additional space, please continue on a separate sheet of paper.

Summarize special skills and qualifications acquired from employment or other experience:______

______

State any additional information you feel may be helpful to us in considering your application.______

______

______AGREEMENTS

Pre-Employment Statement

 I certify that the answers given herein are true, accurate and complete to the best of my knowledge  In the event of employment, I understand that false or misleading information given, in my application or interview(s), may result in immediate discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.  I understand that I may be required to undergo physical examination(s); background and criminal history checks; and drug testing(s) as a condition of employment.  I understand that my employment and compensation can be terminated, with or without cause, and without notice, at any time, at either the option of the Company or myself.

Authorization

 I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.  I authorize any previous employers or educational institutions or individuals specified by me in this application to release any and all information regarding my employment or scholastic standing, together with any other information, personal or otherwise that may or may not be on their records, and I hereby release said employers, educational institutions, or persons from liability for any damage or injury to me arising out of the release of such information.

______Signature of Applicant Date

Rev: 9/200 Better Baked Foods of Erie, LLC Pre-Hire Questionnaire

Applicant Name ______Date______

What position or type of job are you applying for?

How did you find out about positions that may be available at Better Baked Foods?

Are you currently working? If yes, where?

If no, why not?

Do you have reliable transportation? Yes / No

If hired, what shift would you prefer? First / Second / Third / Any

Are you able to work more than eight (8) hours Yes / No per shift?

Are you able to work more than ten (10) hours Yes / No per shift?

Are you able to work weekends? Yes / No

Are you able to be flexible with the start and/or Yes / No end time of a shift?

Have you ever worked in a manufacturing environment? If yes, where?

Have you ever worked in a food manufacturing environment? If yes, where?

Have you ever operated production equipment? If yes, what type?

Are you able to comply with the minimum employment requirements of successful completion of a physical abilities test, substance abuse screening and background checks, as well as have the ability to provide proof of a state recognized diploma or GED? Yes______No______

Better Baked Foods is an equal opportunity employer.