Panera Bread Job Application Form
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1
2PANERA BREAD EMPLOYMENT APPLICATION
PANERA BREAD IS COMMITTED TO MAINTAINING A SMOKE AND DRUG FREE WORKPLACE.
PERSONAL DATA
NAME (LAST)
FIRST
MIDDLE
SOCIAL SECURITY NUMBER
-
-
PRESENT ADDRESS
STREET
CITY
STATE (ZIP CODE)
PHONE
(
)
ARE YOU SIXTEEN YEARS OF AGE OR OLDER?
Yes
Yes
No
No
ARE YOU A CITIZEN OF THE U.S. OR DO YOU HAVE A LEGAL RIGHT TO WORK IN U.S.?
You will be required to provide proper identification at the time of hire.
Part Time
Temporary
Full Time
Summer
_____________(Other)
POSITION APPLYING FOR (And For Which You Are Qualified)
SEEKING:
HOURS AVAILABLE PER WEEK: _________________
STORE LOCATION PREFERRED
: ______________________________
MONDAY :
___________________________
TUESDAY:
___________________________
OTHER AVAILABLE LOCATIONS?
______________________________
WEDNESDAY: ___________________________
THURSDAY:
___________________________
FRIDAY:
___________________________
SATURDAY:
___________________________
DATE AVAILABLE FOR EMPLOYMENT: _________________________
SUNDAY:
___________________________
WITHIN THE PAST FIVE YEARS HAVE YOU BEEN
WERE YOU REFERRED BY ANY CURRENT
HAVE YOU PREVIOUSLY WORKED AT ANY PANERA or SAINT LOUIS
CONVICTED OF A FELONY?
ASSOCIATE AT PANERA BREAD?
BREAD COMPANY?
Yes
Yes
No
No
Yes
No
IF YES, WHEN? WHERE? NATURE AND DISPOSITION OF
IF YES, INDICATE NAME AND LOCATION
IF YES, WHEN AND WHERE?
CONVICTION:
EMPLOYED:
WERE YOU INTERVIEWEDPREVIOUSLY?
Yes
No
IF YES, INDICATE BY WHOM (IF YOU REMEMBER)
Conviction of a felony will not automatically disqualify you from
employment.
EDUCATIONAL DATA
GRADUATED
NAME & ADDRESS OF SCHOOL
MAJOR
MINOR/ADDITIONAL SUBJECTS OF INTEREST
Yes
No
HIGH SCHOOL
COLLEGE/
OTHER
GRADUATE
SCHOOL
EMPLOYMENT HISTORY
List all present and past employment, beginning with your most recent. Please attach additional sheets if necessary.
COMPANY NAME/ADDRESS/TELEPHONE NUMBER:
IMMEDIATE SUPERVISOR:
YOUR JOB TITLE OR POSITION:
(
)
Yes
No
DATES EMPLOYED
IF STILL EMPLOYED, MAY WE CONTACT YOUR PRESENT SUPERVISOR?
IF YES, PLEASE PROVIDE NAME AND PHONE NUMBER
FROM: (Mo/Yr)
TO: (Mo/Yr)
NAME:
(______) _______________EXT.:______
REASON(S) FOR LEAVING:
DESCRIBE YOUR DUTIES:
COMPANY NAME/ADDRESS/TELEPHONE NUMBER:
IMMEDIATE SUPERVISOR:
YOUR JOB TITLE OR POSITION:
(
)
Yes
No
DATES EMPLOYED
IF STILL EMPLOYED, MAY WE CONTACT YOUR PRESENT SUPERVISOR?
IF YES, PLEASE PROVIDE NAME AND PHONE NUMBER
FROM: (Mo/Yr)
TO: (Mo/Yr)
NAME:
(______) _______________EXT.:______
REASON(S) FOR LEAVING:
DESCRIBE YOUR DUTIES:
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Parent category: Business