Job Application for PureBread Deli Please fill out the job application for PureBread Deli and we will get back to you shortly! Name First Last Email Phone Number Address Street Address Address 2 City State / Province Postal / Zip Code Country... Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia & Herzegovina Botswana Brazil British Indian Ocean Ter Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos Island Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Ter Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Hawaii Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Nambia Nauru Nepal Netherland Antilles Netherlands (Holland, Europe) Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Island Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Republic of Montenegro Republic of Serbia Reunion Romania Russia Rwanda St Barthelemy St Eustatius St Helena St Kitts-Nevis St Lucia St Maarten St Pierre & Miquelon St Vincent & Grenadines Saipan Samoa Samoa American San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Is Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (Brit) Virgin Islands (USA) Wake Island Wallis & Futana Is Yemen Zaire Zambia Zimbabwe Country I am 18 Years or Older: Choose One No Yes If You are NOT 18 Years or Older, what is your birthdate? DD MM YYYY Referral Name Location you are interested in: Christiana, DE Pike Creek, DE Greenville, DE Kennett Square, PA Glen Mills, PA Wilmington, DE PureBread Commissary Desired Position Cashier Sandwich Maker Food Runner Manager Assistant Manager Shift Supervisor Food Prep Date Available DD MM YYYY Are you employed? Choose One No Yes May we contact your current employer? Choose One No Yes Phone Number of Current Employer Have you applied to PureBread Deli Before? If Yes, When & Which Location? Preferred Number of Shifts: Hours Wanted Part Time Full Time Over Time Have you ever been to PureBread Deli? Choose One No Yes Why do you want to work at PureBread? Why are you leaving your current job? What is your greatest strength, and greatest weakness? Why should we hire you? Do you prefer morning or afternoon hours? Choose One Morning Hours Afternoon Hours Will your availability change during the year (example: sports, extracurricular activities)? If yes, when? Do you have reliable transportation? Choose One No Yes Schedule of Availability DAY: TO/FROM Monday Availability Tuesday Availability Wednesday Availability Thursday Availability Friday Availability Saturday Availability Sunday Availability CITIZENSHIP The U.S. Government requires that all persons hired after November 6, 1986 must: (1) show the employer original documents which establish identity and work authorization, and (2) complete and sign a form claiming they are eligible to work in the U.S. Examples of acceptable documents (which must be presented upon employment) include: Identity 1) State-issued identification card or driver's license 2) School identification card with photo Work Authorization 1) Social Security Card 2) Certificate of birth in U.S. or 3) Alien Registration Receipt Card Right to work in the United States? Choose One Yes No WORK HISTORY Past Employment - 1 Name and Location of Employer Position Start Date DD MM YYYY End Date DD MM YYYY Salary/Hourly Rate Reason for Leaving Education High School School Name Did you graduate? Choose One No Yes College, Business or Trade School School Name Course of Study Years Attended Did you graduate? Choose One No Yes Other Have you ever been convicted or plead guilty to a crime? (excluding traffic violations or misdemeanors) If yes, describe in full: * General What additional relevant experiences or training have you had other than your work experience, military service, or education? Activity Civic, athletic, fraternal, etc.(Exclude organizations which indicate race, religion, color, or national origin of members) Acknowledgment of Truthfulness of Application I understand that PureBread Deli has a right to rely upon the truthfulness of all statements in the Employment Application. If I am later hired and any statement on this Employment Application is at any time found to be untrue, PureBread Deli retains the right to terminate my employment. I further understand that if I am hired, I will be an "Employee at Will" This means I am free to terminate my employment at any time for any reason with or without cause and PureBread Deli Management retains the same right. Everything in this application is true. If you're not a fish leave this field blank: