PARLOR DOUGHNUTS

APPLICATION FOR EMPLOYMENT
PARLOR DOUGHNUTS

Please complete all sections of the application form so that your qualifications may be fully considered. It is the policy of Parlor Doughnuts to be full compliance with all applicable federal and state non-discrimination and equal opportunity laws and regulating to race, color, sex, religion, disability, age, national origin, veteran status, or any other category protected under federal, stated or local law.
Position(s) Desired
Date Available

MonthDayYear
Date
(Last)
(First)
(Middle)
Email Address
example@example.com
Salary desired
Are you 18 years or older? (Individuals who are 14-17 years may be required to provide a work permit.)

YesNo
Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment.)*

YesNo
Phone Number*
Please enter a valid phone number.
How did you learn of this position?*

AdWebsiteIndividual
I am seeking ( check all that are applicable):

Full-TimePart-Time
I am willing to work (check all that are applicable):

DaysEveningsRotating shiftsWeekends
If you need to work around another schedule (e.g. school), please provide any details that need to be coordinated/considered
Indicate any other technology skills you possess that would be applicable for the position, including Point of Sale (POS) systems
Summarize special skills/qualifications or other experience that may qualify you to work Parlor Doughnuts. (Exclude those which indicate race, color, sex, religion, disability, age, national origin, or any other protected category.)
Do you speak a second language?

YesNo
If yes, please list
Employement History

Beginning with your current / most recent employment please complete the section below in full. Incomplete information could disqualify you from further consideration
Company
Job Title
From (mo/yr)
To (mo / yr)
Address

Address

Street Address Line 2

City / State / ZipState / Province

Postal / Zip Code
Final Salary
Supervisor
Duties
Reason for Leaving
Amount of notice given
Company
Job Title
From (mo/yr)
To (mo/yr)
Address

Address

Street Address Line 2

City / State / ZipState / Province

Postal / Zip Code
Final Salary
Supervisor
Email
example@example.com
Duties
Reason for Leaving
Amount of notice given
Company
Job Title
From (mo/yr)
To (mo/yr)
Address

Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Final Salary
Supervisor
Email
example@example.com
Duties
Reason for Leaving
Amount of notice given
Company
Job Title
From (mo/yr)
To (mo/yr)
Address

Address

Street Address Line 2

City / State / ZipState / Province

Postal / Zip Code
Final Salary
Supervisor
Email
example@example.com
Duties
Reason for Leaving
Amount of notice given
Have you ever been discharged from a position or asked to resign from a position in lieu of being discharged?
If yes, please explain
Professional References

List individuals who can provide information about your employment, volunteer activities, or professional experiences (do not list relatives Please do not list supervisors who have already been identified on the previous page.
Name
Company
Occupation / Relationship
Number of Years Known
Phone Number
Email
example@example.com
Name
Company
Occupation / Relationship
Number of Years Known
Phone Number
Email
example@example.com
Name
Company
Occupation / Relationship
Number of Years Known
Phone Number*
Phone Number
Please enter a valid phone number.
Email
example@example.com
Applicant Certification and Agreement

In exchange for the consideration of my job application with the Company, I agree that:
I agree, if I am offered and accept a position, to conform to all existing and future Company rules and regulations, and I understand that Company reserves the right to change wages, hours and working conditions as deemed necessary.
Please initial here.
I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), and others about me as deemed appropriate by the Company, and hereby release the Company from any liability as a such contract.
Please initial here.
I understand that any employment offer is contingent upon my providing, within three working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986.
Please initial here.
I have read and reviewed the information provided in this application and the above statements. I certify that the facts and information set forth in this application, are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts on the application, resume and any attachments (or on any required document)will be cause for denial of employment or termination of employment, regardless of when or how it was discovered.
Please initial here.
Signature

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Date

MonthDayYear
Date
Phone Number
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Phone Number*
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APPLICATION FOR EMPLOYMENT

PARLOR DOUGHNUTS