Fillable Panera Bread Job Application Form (Page 2 of 2) in pdf

COMPANY NAME/ADDRESS/TELEPHONE NUMBER:

IMMEDIATE SUPERVISOR:

YOUR JOB TITLE OR POSITION:

(

)

Yes

IF YES,

PLEASE PROVIDE NAME AND PHONE NUMBER

DATES EMPLOYED

IF STILL EMPLOYED, MAY WE CONTACT YOUR PRESENT SUPERVISOR?

FROM: (Mo/Yr)

TO: (Mo/Yr)

NAME:

(______) _______________EXT.:______

REASON(S) FOR LEAVING:

DESCRIBE YOUR DUTIES:

OTHER ACCOMPLISHMENTS

Please list below any other job related accomplishments, professional distinctions, certifications, or verifiable volunteer work that STLBC should know about.

MILITARY HISTORY

DATES OF SERVICE

MILITARY SERVICE STATUS

BRANCH OF SERVICE

From

VETERAN

NON-VETERAN

NATIONAL GUARD

RESERVES

ADVANCED ROTC

Yes

DID YOU RECEIVE ANY MILITARY TRAINING RELATED TO THE JOB FOR WHICH YOU ARE APPLYING?

IF YES, PLEASE EXPLAIN:

REFERENCES

NAME

ADDRESS

OCCUPATION/TELEPHONE #

Occupation:

Telephone #: (

)

Occupation:

Telephone #: (

)

SIGNATURE

(Please read carefully before signing)

I certify that the answers given herein are true and complete to the best of my knowledge, and I authorize investigation of all statements contained in this application, with exception of contacting my present

employer if I have so requested on page two. I have read, understand and agree to the above statement. (please initial here) _______

While this application will be retained on file for a period of one year (as required by law), I acknowledge that this application will be considered active for a period of sixty (60) days. At that time, I must submit a

new application to be considered for any employment openings. I have read, understand and agree to the above statement. (please initial here) ________

I understand and acknowledge that unless otherwise defined by applicable law or written agreement with Panera Bread, any employment relationship with the Company is considered “employment at will,” which

means the employee may resign at any time and the Employer may discharge the Employee at any time, with or without cause. It is further understood that this “at will” employment relationship may not be

changed by any written document or by any conduct unless such change is specifically executed by the President/Vice President of Panera Bread. I have read, understand and agree to the above statement.

(please initial here) ______

If I should be employed by the Company, I understand that any false, incomplete, or misleading information given on this application or during an interview shall result in immediate discharge. I have read,

understand and agree to the above statement. (please initial here) ________

I authorize an inquiry into my background by all people, schools, companies, corporations, credit bureaus, law enforcement agencies, doctors and other consumer reporting agencies to supply information

concerning my previous employment, education, credit, driving record, etc. I have read, understand and agree to the above statement. (please initial here) ________

I authorize the references listed above to give representatives of Panera Bread any and all information concerning my previous or current employment and any pertinent information they may have, personal or

otherwise, and release all parties from any and all liability from any damage that may result. I have read, understand and agree to the above statement. (please initial here) ________

SIGNATURE

DATE

Panera Bread is an Equal Opportunity Employer. Panera Bread does not discriminate in employment and no question on this application is used for the purpose

of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state or federal law.