Employment Application

We consider applications for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital, or veteran status, or any other legally protected status.

Please note that resumes will not be accepted in place of a fully completed application.

Personal Information
Name *
Name
Phone *
Phone
Alternate Phone
Alternate Phone
Physical Address *
Physical Address
Background
Are you a U.S. Citizen? *
Do you have a Driver's License valid in NH? *
If you leave this space blank, you certify that you have no history of automobile accidents or traffic violations within the past 5 years.
If hired, are you willing to undergo a background check? *
Have you ever been convicted of a felony? *
If you leave this space blank, you certify that you have no current record of conviction.
Position & Availability
Available Start Date *
Available Start Date
Desired Employment Type *
Example: "Tuesdays 8am - 4pm"
Education
College/University/High School
Did you graduate? *
Graduation Date *
Graduation Date
Previous or anticipated.
Attained or in progress.
Employment History
Please provide your employment history starting with your most recent employer.

NOTE: Please re-name files to include your name to ensure ease of locating.
Ex: john-doughs-resume.pdf
Start Date *
Start Date
End Date
End Date
Leave blank if still employed.
$
Write "N/A" if still employed.
Start Date *
Start Date
End Date
End Date
Leave blank if still employed.
$
Write "N/A" if still employed.
Start Date
Start Date
End Date
End Date
Professional References
Please provide three (3) professional references that do not include family members or supervisors listed in Employment History.
Name Title Company Phone
Name Title Company Phone
Name Title Company Phone
Certification, Authorization, & Signature
I hereby authorize and consent to the release of any information maintained about me by all previous employers, education institutions, law enforcement authorities, licensing boards or any other entity, agency, or individual which The Bread Shed may contact to secure references, with the specific exception of the following people: . Except as specifically noted above, I release all individuals and entities from legal liability in providing relevant information and opinions that may be useful in making a hiring decision. I hereby authorize The Bread Shed to release information concerning my employment to any prospective employer or others seeking to verify my employment with the company. I hereby release The Bread Shed from all liability for any truthful statement made by any employee, agent, or official of the company, which is made to any perspective employer, and waive any claim that might arise from any such statement. I understand that if I am hired, there may be a 90-day introductory period, but I understand and acknowledge that there is no specified length to my employment at The Bread Shed, and that my employment is at will. I understand and acknowledge that “at will” means I may terminate my employment at any time, with or without cause or advanced notice. I also understand and acknowledge that “at will” means that The Bread Shed may terminate my employment at any time, with or without cause or advanced notice, as long as they do not violate federal or state laws. If my job results in my having proprietary information, I will be required to sign a non-compete and non-disclosure agreement as a condition of employment. I understand and give permission for the organization to conduct a pre-employment drug screening. I also understand that there is a no-smoking policy and that I will not be allowed to smoke inside any company structure or vehicle. I certify that the statements I made are true and complete to the best of my knowledge. I further understand that any false statements or omissions made on this application or supplement may be grounds for immediate discharge or for removal from consideration of employment. By typing your full, legal name below, you are certifying that you have read, and agree, to the above statement.
Today's Date *
Today's Date