BAUMAN COLLEGE Employment Verification Form

Graduate Information
First Name*
Last Name*
Email*
example@example.com
Group #
Graduated*
Month
Grad Year*
Year
Home Phone*
Cell Phone*
Which program have you most recently graduated from?*

Nutrition Consultant - IDLHolistic Chef - IDL
What is your current employment status?

I am working as a Holistic Chef, or a Nutrition Consultant, and/or working in my respective field and incorporating Nutrition information to enhance my workI am not currently working as a Holistic Chef, or a Nutrition Consultant

Primary Job: Employment Details
Please indicate the employment status that best describes your primary work situation:*

Employee (hired by a company as an employee; You receive a W2 tax form)Independent Contractor (working within a company; You receive a 1099 tax form)Private Practice (Self employed)
Does your employer consider you Part time or Full time?*

Part TimeFull Time
Please indicate average days per week you are scheduled to work:*
Company or Business Name*
Name of your practice if different from company
Primary contact within the company
Contact Phone Number
Contact Email
example@example.com
Holistic Chef Industry (choose all that apply)*

Personal / Private CheffingCommercial Kitchen - CafeCommercial Kitchen - Catering / Food PrepCommercial Kitchen - RestaurantSchool - Food EducationSchool - CafeteriaWellness CenterRecipe TestingFood PhotographyCulinary Blogging, Health Writers + AuthorsOther
Nutrition Consultant Industry (choose all that apply)*

Private Nutrition ConsultingFood Prep / CateringResearch, Recipe TestingNutrition Education (Workshops / Courses)Wellness CenterHealth Writers, Bloggers + AuthorsNutrition Blogging or WritingSchool Cafeteria / School (providing education)Other
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer’s Phone Number*
Do you have a website, or Social Media platform (Instagram, TikTok, Facebook, etc.)?
Supervisor’s first and last name*
Date Hired*

MonthDayYear
Approximate date you began your practice and/or started seeing clients*

MonthDayYear
Holistic Chef Job Title*

Holistic ChefChefHead ChefSous ChefOther
Nutrition Consultant Job Title*

Nutrition ConsultantNutritionistNutrition PractitionerHolistic Nutrition ConsultantOther
Thank you in advance for helping us collect accurate industry data:
Are you willing to state wage information?*

YesNo
Average amount earned per 1-hour of work completed*
Average paid hours per week: (paid at either an hourly rate, or combined with your respective position, or hours you charge for your services)*
Average unpaid hours per week: (office hours, travel, marketing, Food prep, etc.)*
Out of 52 weeks in a year, how many weeks do you anticipate working at this job?*
Did you perform any student Externship/Practicum hours at the location where you work?*

YesNo
Did you obtain any of your current clients and/or this work space through your student Externship/Practicum?*

YesNo
Employment Statement
Please confirm that you are employed in your training related field*

YES I acknowledge that I am employed as a Nutrition Consultant and that I am earning training related income.
Please confirm that you are employed in your training related field*

YES I acknowledge that I am employed as a Holistic Chef and that I am earning training related income.
Please confirm that you are employed in your training related field*

YES I acknowledge that I am satisfied with part-time employment as a Nutrition Consultant and that I am earning training related income.
Please confirm that you are employed in your training related field*

YES I acknowledge that I am satisfied with part-time employment as a Holistic Chef and that I am earning Training related income.
Self-Employment Statement
Please confirm that you are choosing to be self-employed in your training related field (i.e. Pursuing your own private practice or working as an independent contractor).*

YES I acknowledge that I am satisfied with self-employment as a Nutrition Consultant and that I am earning training related income.
Please confirm that you are choosing to be self-employed in your training related field (i.e. Pursuing your own private practice or working as an independent contractor).*

YES I acknowledge that I am satisfied with self-employment as a Holistic Chef and that I am earning training related income.

To finish, press submit
Should be Empty:

Graduate Information

Bauman College Placement Assistance - WAIVER

Primary Job: Employment Details

Thank you in advance for helping us collect accurate industry data:

Employment Statement

Self-Employment Statement