GHBC-A Job Application Form 2025

GREAT HARVEST BREAD CO.

ANCHORAGE, ALASKA
Jarrett Grains

dba Great Harvest Bread Co.

570 E. Benson Blvd, Suite 22, Metro Mall

Anchorage, Alaska 99503

(907) 274-3331
APPLICATION FOR EMPLOYMENT
PERSONAL INFORMATION:
Name:
Present Address:
Permanent Address (if applicable):
Phone Number:
Email:
example@example.com
EMPLOYMENT INFORMATION:
Position for which you are applying:

Sales CounterProduction Work
Date You Can Start:

MonthDayYear
Date
Preferred Working Hours:
Desired Hourly Wage:
Desired Total Hours Per Week:
How did you learn about Great Harvest?
What are your goals for the next six to twelve months?
EMPLOYMENT HISTORY:

(List your three most recent employers, starting with the most recent)
Employer #1
Employer's Name & Address
Position Held
Period of Employment
Month/Year to Month/Year
Name & Phone # of Contact Person / Reference
Employer #2
Employer's Name & Address
Position Held
Period of Employment
Month/Year to Month/Year
Name & Phone # of Contact Person / Reference
Employer #3
Employer's Name & Address
Position Held
Period of Employment
Month/Year to Month/Year
Name & Phone # of Contact Person / Reference
EDUCATION:

(Please complete all blanks that apply)
High School
Date of Attendance
Month/Year to Month/Year
College
Date of Attendance
Month/Year to Month/Year
Other
Date of Attendance
Month/Year to Month/Year
Degrees or Certifications Received, or Special Topics Studied
Please list any unique/exceptional skills:
What recent activities or accomplishments have you found particularly satisfying and why?
Describe an ideal work environment. What would you offer to the Great Harvest work environment?
PERSONAL REFERENCES:

(Please do not list relatives)
Reference #1
Name
Phone
Address
How do you know this person?
Reference #2
Name
Phone
Address
How do you know this person?
Reference #3
Name
Phone
Address
How do you know this person?
PHYSICAL RECORD:
Can you perform the functions of this job with or without accommodation, including lifting regularly, stooping and bending frequently, performing repetitive hand motions, and remaining on your feet for long periods?

YesNo
Describe your performance with reasonable accommodations:
In case of emergency notify:
(Name & Relationship, Address, Phone Number
OTHER:
Within the past five years, have you been charged with or convicted of any crime?

YesNo
If so, in which State?
Please describe:
AUTHORIZATION: I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I further authorize investigation of all statements contained herein and contact with the references listed above.
Signature*

Clear
Date*

MonthDayYear
Date
Please note: As a job applicant, you may request any needed accommodation to participate in the application process, such as special arrangements for a job interview. We regret that because of the number of applications we receive, we will not be able to respond personally to every application. You will be called if we are able to interview you. Thank you very much for your time & interest in Great Harvest Bread Co. - Anchorage!
Should be Empty:

GREAT HARVEST BREAD CO.

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION:

EMPLOYMENT INFORMATION:

EMPLOYMENT HISTORY:

Employer #1

Employer #2

Employer #3

EDUCATION:

PERSONAL REFERENCES:

Reference #1

Reference #2

Reference #3

PHYSICAL RECORD:

OTHER: