| First Name: * | |
| Last Name: * | |
| Address: * | |
| City: * | |
| State: * | |
| Zip: * | |
| Phone Number: * | |
| Cell Number: | |
| E-mail Address: * | |
| Best Time to Reach You: * |
Morning
Afternoon
Evening
Night |
| What days of the week are you available to work? * | Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday |
| Please describe the hours you are available to work: * | |
| Available Start Date: * | |
| Why do you want to work for Madwoman Foods? * | |
| Previous Employer #1: | |
| Dates Employed: | |
| Supervisor Name: | |
| Phone: | |
| Job Duties at Previous Employer: |
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| Dates Employed: | |
| Previous Employer #2: | |
| Supervisor Name: | |
| Phone: | |
| Job Duties at Previous Employer: |
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| Do you have knowledge of food allergies? * |
Yes
No |
| Do you have any food allergies or constraints that may make it difficult for you to work in food preparation? * |
Yes
No |
| If yes, please list food allergies: | |
| Do you know what gluten is and why one would need to avoid it? * |
Yes
No |
| Bakeshop positions include helping in the kitchen as well as front counterwork. They have all of the following job requirements: occasional lifting, sometimes above the head items weighing 25 lbs or more, pushing, pulling, bending, lateral movements, standing and/or walking for several hours at a time, operating mechanical equipment, exposure to temperature extremes, good manual dexterity, ability to perform basic mathmematical calculations. Do you have any physical limitations that would inhibit your performance of these duties? * |
Yes
No |
| Please tell us something about yourself: * | |
| Additional Information: |
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| * Required | |