Bruegger's Bagels

East Coast Bagels & Cafe Online Employment Application

East Coast Bagels & Cafe, LLC. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.
Name First Last
Please enter your first and last name.
Address
Street Address

City

State / Province / Region

Postal / Zip Code

Please enter your address.
Email

Please enter your email below ex. johndoe@aol.com
Phone Number - (###) - ### ####
Please enter your phone number where we can reach you.
Alternative Phone Number - (###) - ### ####
Please enter an additional phone number.
Are you over 18 years of age? Yes No
Please click "yes" if you are over the age of 18. Click "no" if you are younger then the age of 18.
Are you legally eligible for employment in the United States? Yes No
Please click "yes" if you are eligible. Click "no" if you are not.
Have you ever been employed in any Bruegger’s Bakery? If so, location and dates of employment.

Please enter the location and dates of employment. Enter "no" if you have never been employed with Bruegger's before.
Record of Conviction _______________________________________________________
During the last ten years, have you ever been convicted of a crime other than a minor traffic offense? If yes, explain:

Please explain your convicted crime. If you haven't been convicted of a crime, just put "no".
(A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered. If offered employment, you will be required to provide documentation to verify eligibility.)
Education ________________________________________________________
High School Name

Please enter the name of your high school.
High School Address
City

State / Province / Region

Please enter your high school address.
Did you graduate? Yes No
Please click "yes" if you graduated high school. Click "no" if you did not.
College and/or Vocational School Name

Please enter the name of the college and/or vocational school you are attending/attended.
College and/or Vocational School Address
City

State / Province / Region

Please enter the address of the college and/or vocational school you are attending/attended.
Last year completed

Please select how many years you have completed.
Did you graduate? Yes No
Please click "yes" if you graduated. Click "no" if you did not.
PROFESSIONAL LICENSE OR MEMBERSHIP: ________________________________________________________
(You need not disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.)
Type of License(s) Held

Please enter the type of license(s) you have held.
State and License Number
License Expiration Date / MM / DD YYYY
Please enter you license expiration date.
Other Professional Memberships

Please list any other professional memberships.
Positions ________________________________________________________
Position Sought

Please tell us about the position you are seeking.
Full Time or Part Time Full Time Part Time
Please click "full time" or "part time".
How soon can you start work?

Please enter when you are avaliable to start work.
Total hours avaliable per week?
Desired Wage

Please enter your desired wage. ex. $7.00
Avaliable Hours

Please tell us when you are avaliable to work. ex. mon 9 - 5pm
Employment History _________________________________________________________
Company Name 1

Please enter your previous companies name.
Company Address
City

State / Province / Region

Please enter your previous companies address.
Job Title

Please enter your job title.
Begin Date / MM / DD YYYY
Please enter the date you started work.
End Date / MM / DD YYYY
Please enter the date you stopped work for them.
Starting / Ending Wages

Please enter your starting and ending wages.
Supervisor
Reason for leaving

Please tell us why you left.
May we contact your employer? Yes No
Please click "Yes" if we may contact your employer. Click "No" otherwise.
_______
Company Name 2

Please enter your previous companies name.
Company Address
City

State / Province / Region

Postal / Zip Code

Please enter your previous companies address.
Job Title

Please enter your job title.
Begin Date / MM / DD YYYY
Please enter the date you started work.
End Date / MM / DD YYYY
Please enter the date you stopped work for them.
Starting / Ending Wages

Please enter your starting and ending wages.
Supervisor
Reason for leaving

Please tell us why you left.
May we contact your employer? Yes No
Please click "Yes" if we may contact your employer. Click "No" otherwise.
_______
Company Name 3

Please enter your previous companies name.
Company Address
City

State / Province / Region

Please enter your previous companies address.
Job Title

Please enter your job title.
Begin Date / MM / DD YYYY
Please enter the date you started work.
End Date / MM / DD YYYY
Please enter the date you stopped work for them.
Starting / Ending Wages

Please enter your starting and ending wages.
Supervisor
Reason for leaving

Please tell us why you left.
May we contact your employer? Yes No
Please click "Yes" if we may contact your employer. Click "No" otherwise.
_______
Company Name 4

Please enter your previous companies name.
Company Address
City

State / Province / Region

Please enter your previous companies address.
Job Title

Please enter your job title.
Begin Date / MM / DD YYYY
Please enter the date you started work.
End Date / MM / DD YYYY
Please enter the date you stopped work for them.
Starting / Ending Wages

Please enter your starting and ending wages.
Supervisor
Reason for leaving

Please tell us why you left.
May we contact your employer? Yes No
Please click "Yes" if we may contact your employer. Click "No" otherwise.
_______
References (list 3 (not related) who have known you for 5 or more years) _________________________________________________________
Name First Last
Please enter the reference's name.
Address
City

State / Province / Region

Please enter the reference's address.
Phone - (###) - ### ####
Please enter the reference's phone number.
_______
Name First Last
Please enter the reference's name.
Address
City

State / Province / Region

Please enter the reference's address.
Phone - (###) - ### ####
Please enter the reference's phone number.
_______
Name First Last
Please enter the reference's name.
Address
City

State / Province / Region

Please enter the reference's address.
Phone - (###) - ### ####
Please enter the reference's phone number.
APPLICANT'S CERTIFICATION AND AGREEMENT _________________________________________________________
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize East Coast Bagels & Cafe, LLC to verify their accuracy and to obtain reference information on my work performance. I hereby release East Coast Bagels Cafe, LLC from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause. I understand that the Company requires the successful completion of a urinalysis for drug testing purposes and/or a blood alcohol test as a condition of employment. By submitting this Application for Employment, I hereby consent to either or both of said tests, at the Company’s discretion.
Signature of Applicant

Please read and sign.
Date / MM / DD YYYY
Please enter today's date.
RELEASE AND AUTHORIZATION FOR BACKGROUND AND REFERENCE INVESTIGATION _________________________________________________________
In connection with my application for employment (including contract for services), I understand that investigative background inquiries are to be made on me which may include criminal convictions, motor vehicle, and other reports. These reports may include information as to my character, work habits, performance, education and experience along with reasons for termination of employment from previous employers. Further, I understand that you will be requesting information from various Federal, State, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil and other experiences. If I include a current employer for verification, I may jeopardize my position within that company. I authorize without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from any liability and responsibility for doing so. This authorization and consent shall be valid in original, fax or copy form. I further authorize ongoing procurement of the above-mentioned reports at any time during my employment (or contract) . I am aware that the result of any background investigation performed by Employer and/or its designees is not the sole criteria used by the Employer in making a decision to hire or not hire any individual, including me. I am also aware that any falsification or misrepresentation of information appearing on my application for employment shall be grounds for my not being hired or for my being terminated. I have carefully read this Release and Authorization for Background and Reference Investigation and have voluntarily agreed to its terms to assist Employer in evaluating my qualifications for employment and in meeting the business necessity of hiring honest, trustworthy, reliable, and nonviolent employees. I additionally agree to fully cooperate with Employer in permitting the release of the above information and reports. Finally, understand that with the exception of any credit reports, all information generated, received or maintained during or as a result of its investigation, will be maintained as confidential information and that Employer will not release such information to me.
Signature of Applicant

Please read and sign.
Date / MM / DD YYYY
Please read and sign.

Bruegger's Bagels

Bruegger's Bagels

East Coast Bagels & Cafe, LLC. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.

Record of Conviction _______________________________________________________

Education ________________________________________________________

PROFESSIONAL LICENSE OR MEMBERSHIP: ________________________________________________________

(You need not disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.)

Positions ________________________________________________________

Employment History _________________________________________________________

_______

_______

_______

_______

References (list 3 (not related) who have known you for 5 or more years) _________________________________________________________

_______

_______

APPLICANT'S CERTIFICATION AND AGREEMENT _________________________________________________________

RELEASE AND AUTHORIZATION FOR BACKGROUND AND REFERENCE INVESTIGATION _________________________________________________________