Employment Application Form

Ithaca Bakery & Collegetown Bagels Employment Application

Living Wage Statement
Ithaca Bakery & Collegetown Bagels are very proud to be a Living Wage employer, in fact the largest privately owned living wage employer in Tompkins County. We are extremely proud to be able to make this commitment as a fair and equitable employer in the community. With the living wage in Ithaca currently at $15.37 per hour, according to the AFCU Living Wage Study, with tips and health insurance contribution (where applicable) we are paying a wage that is far above both the minimum wage and what is typical for the food industry. In addition, we provide many additional benefits like: discounts, retirement plan with matching, meal credits, dental insurance, medical insurance, paid benefit time and holiday pay.
Name: *

First Name Last Name
Phone Number: *

Area Code Phone Number
E-mail Address: *
Local Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Permanent Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How were you referred to us?

Walk-In Employee (tell us who!) Facebook Craigslist Other (please specify)
Others:
Upload Resume:
Job Skills & Training
Describe your skills:
Training or Certifications:
If you are under 18, do you have a work permit?

Yes No
Have you ever applied for work with us before?

Yes No
Have you ever worked for Collegetown Bagels before?

Yes No
If yes, when?
Do you know anyone who is/has been employed at Collegetown Bagels? If yes, who?
Please check position desired (check all you are interested in)

Manager Office Driver Retail & Retail Support Catering Custodial Entree & Salad Production Bread & Bagel Production Pastry Production Packer Dishwasher
How many hours are you looking for? (check all that apply)

Full Time (+33 hours) Part Time (-33 hours) Temporary (less than 1 year)
When can you start?
How long do you plan to be with our company?
Please list dates and times you are available to work.
Will you work weekends?

Saturday Sunday Both None
At which store are you available to work? (Please check all that apply)

Collegetown Bagels (420 College Ave.) Collegetown Bagels (301 E. State St.) Collegetown Bagels (East Hill Plaza) Ithaca Bakery (400 N. Meadow St.) Ithaca Bakery (Triphammer Marketplace)
Do you have the ability to carry cases of soda up and down stairs or to stand on your feet for long periods of time? Yes or No? If No, please explain.
Have you ever been convicted of a crime? Yes or No? If Yes, please explain.
Education & Training
High School
College or Technical School
Special Training
References

Please provide the names of two persons, not related to you, whom you have know for at least one year.
Reference 1
Name:

First Name Last Name
Phone Number

Area Code Phone Number
Relationship
Years Known:
Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Reference 2
Name:

First Name Last Name
Phone Number

Area Code Phone Number
Relationship
Years Known:
Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Employment History

Please list your last 3 employers (most recent first)
Employer 1
Employer Name
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Employer Phone

Area Code Phone Number
Employer Email
example@example.com
Employer Address
Supervisor's Name & Title
Duties & Responsibilities
Reason for Leaving
May we contact this employer?

Yes No
If no, why not?
Employer 2
Employer Name
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Employer Phone

Area Code Phone Number
Employer Email
example@example.com
Employer Address
Supervisor's Name & Title
Duties & Responsibilities
Reason for Leaving
May we contact this employer?

Yes No
If no, why not?
Employer 3
Employer's Name
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Employer Phone

Area Code Phone Number
Employer Email
example@example.com
Employer's Address
Supervisor's Name & Title
Duties & Responsibilities
Reason for Leaving
May we contact this employer?

Yes No
If no, why not?
Questions

Please answer the following questions.
What applicable skills and/or experience could you bring to Collegetown Bagels?
What do you think your references would name as your greatest strength?
What do you think your references would name as your greatest weakness?
What are your career goals? Where do you see yourself in one year, five years, ten years?
Please describe an experience in which you have given or received excellent customer service.
As an employee, what do you expect from supervisors, managers or owners?
Describe your fantasy meal (food only, please).
Should be Empty:

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