Fillable Printable Panera Bread Application for Employment Form
Fillable Printable Panera Bread Application for Employment Form
Panera Bread Application for Employment Form
APPLICATION FOR EMPLOYMENT
Name (Last) First Middle Initial
Social Security Number
Present Street Address
City/State
Zip Code
Phone number
Are you a citizen of the U.S. or do you
have a legal right to work in the U.S.? Yes No
Any offer of employment is conditioned upon completing for I-9
And providing documents establishing identity and work authorization.
Position Applying for:
Bakery Cafe Location preferred:
Full Time Part Time
In the past 5 years have you been c onvi ct ed
Of a felony relating to theft or dishonesty? Yes No
If Yes, when?
Where?
Nature and disposition of conviction:
Have you previously applied for employment
with Saint Louis Bread or Panera Bread? Yes No
If Yes, when?
Where?
Are you related to any associate employed
by Saint Louis Bread or Panera Bread? Yes No
If Yes, indicate name, relationship and location:
Date available for
employment:
Are you 18 years
of ages or older?
Yes
No
If under 18 years of age, applicant will be required to submit a
birth certificate or work certificate as required by State or Federal
Law.
Name and address of last school attended:
Dates attended:
From To
Graduated?
Yes No
Date of
Degree
Major Minor
Are you presently
Enrolled in school? Yes No
If Yes, give name and address of school:
Day Night
List any other education, accomplishments or special interests:
Availability
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
From
To
Total hours per week available for work:
How far do you live from the restaurant?
References
Name/Occupation Address Phone
Employment History
(List all present and past employment with the most recent.)
Company Name and Address:
Immediate supervisor:
Phone:
( )
Pay rate at time of employment:
Dates of employment:
From: To:
Reason for leaving: (If applicable)
Job Title:
May we contact
This employer? Yes No
Company Name and Address:
Immediate supervisor:
Phone:
( )
Pay rate at time of employment:
Dates of employment:
From: To:
Reason for leaving: (If applicable)
Job Title:
May we contact
This employer? Yes No
Company Name and Address:
Immediate supervisor:
Phone:
( )
Pay rate at time of employment:
Dates of employment:
From: To:
Reason for leaving: (If applicable)
Job Title:
May we contact
This employer? Yes No
Declaration
(Carefully read and initial each section then sign at bottom)
I certify that the answers given herein are true and complete to the best of my knowledge, and I authorize investigation of all statements
contained in this application, with the exception of contacting my present employer if I have so requested. I have read, understand and agree to
the above statement.
(Please initial here)
I understand that my continued employment will depend upon the successful c ompletion of work assigned to me during a new hire period of up
to ninety (90) days and upon my continued successful perfor mance. I have read, understand and agree to the above statement.
(Please initial here)
While this application will be retained on file for a period of one year. I acknowledge that this application will be considered active for a period
of sixty (60) days. At that time, I must submit a new application to be considered for any employment openings. I have read, understand and
agree to the above statement.
(Please initial here)
I understand and acknowledge that unless otherwise defined by applicable law or written agreement with Panera Bread, any employment
relationship with the Company is consi dered “employment at will”, which means the employee may resign at any time and the Employer may
discharge the Employee at any time, with or without cause. It is further understood that this “at will” employment relationship may not be
changed by any written document or by any conduct unless such change is specifically executed by the President/CEO of Panera Bread. I have
read, understand and agree to the above statement.
(Please initial here)
If I should be employed by the Company, I understand that any false, incomplete, or misleading information given on this application or during
an interview shall result in immediate discharge. I have read, understand and agree to the above statement.
(Please initial here)
I authorize an inquiry into my background by all persons, schools, companies, corporations, credit bureaus, law enforcement agencies, doctors
and other consumer reporting agencies to supply information concerning my previous employment, education, credit, driving record, etc. I have
read, understand and agree to the above statement.
(Please initial here)
I authorize the references listed above to give representatives of Panera Bread any and all information concern ing my previous or current
employment and any pertinent information they may have, personal or otherwise, and release all parties from any and all liability from any
damage that may result. I have read, understand and agree to the above statement.
(Please initial here)
Signature:
Date:
