Bakery Application

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Orr’s Farm Market

Bakery Employment Application:

Applicant Information

Full Name: Date:


Last First M.I.

Address:
Street Address Apartment/Unit #

City State ZIP Code

Phone: Email

Date Available: Social Security No.: Desired Salary:$

Availability-Please write hours you are available each day in boxes below.
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

List any other pertinent information about your scheduling (activities, school schedules, etc.):

Position Applied for: Bakery Employee

YES NO YES NO
Are you a citizen of the United States? If no, are you authorized to work in the U.S.?

YES NO
Have you ever worked for this company? If yes, when?

YES NO
Have you ever been convicted of a felony? If yes, explain:___________________________________

YES
Are you at least 18 years of age?

Education

High School: Address:

YES NO
From: To: Did you graduate? Diploma::

College: Address:

YES NO
From: To: Did you graduate? Degree:

Other: Address:

YES NO
From: To: Did you graduate? Degree:

References
Please list two professional references.

1
Full Name: Relationship:
Company: Phone:
Address:

Full Name: Relationship:


Company: Phone:
Address:

Previous Employment

Company: Phone:

Address: Supervisor:

Job Title: Starting Salary:$ Ending Salary:$

Responsibilities:

From: To: Reason for Leaving:

YES NO
May we contact your previous supervisor for a reference?

Company: Phone:

Address: Supervisor:

Job Title: Starting Salary:$ Ending Salary:$

Responsibilities:

From: To: Reason for Leaving:

YES NO
May we contact your previous supervisor for a reference?

Disclaimer and Signature


I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may
result in my release.

Signature: Date:

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