WHOLE FOODS JOB APPLICATION - DOC

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					MADWOMAN FOODS JOB APPLICATION


Policy
Your information will be collected, used, and disclosed by Madwoman Foods in connection with the
application and hire process only. The information may be used for such purposes as assessing your
suitability for employment with Madwoman Foods, conducting background investigations, or verifying
information about you.


                         Madwoman Foods is an equal opportunity employer.

Please print clearly and answer each question thoroughly. Sign and date this application form on the
last page.

Personal Information

Full Legal Name: _______________________________________________________________

Phone #: _______________________________________________

Alternate Phone #: ____________________________________________

Best Time to Call: _____________________________________________

E-mail address: _______________________________________________


Current Address: _____________________________________________________________

City: _________________________________________State:___________ Zip:__________

If less than 2 years

Previous Address: ____________________________________________________________

City: _________________________________________ State:___________ Zip:_________



Limitations:

Bakeshop positions include helping in the kitchen as well as counterwork. They have all of the
following job requirements:
 - occasional lifting, sometimes above the head items weighing 25 lbs. or more
 - pushing, pulling, bending, lateral movement
 - standing and/or walking for several hours at a time
 - operating mechanical equipment
 - exposure to temperature extremes
 - good manual dexterity
 - ability to perform basic mathematical calculations
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Do you have any physical limitations that would inhibit your performance of these duties?
 ______Yes ______No

Employment Desired

Why do you want to work for Madwoman Foods?




If hired, when would you be available to start?
 ______Right Now
 ______Specific Date: ______________


Desired Schedule?
 ______Full Time
 ______Part Time
 ______Full Time (Seasonal)
 ______Part Time (Seasonal)
 ______Any


Hours available:

______Monday ______Tuesday ______Wednesday ______Thursday ______Friday

______Saturday ______Sunday

Skills and Qualifications:

List licenses, skills, training, and awards that might pertain to this position:


Do you have knowledge of food allergies?

______Yes ______No

Do you have any food allergies or constraints that may make it difficult for you to work in food
preparation?

______Yes ______No

    If yes, please list food allergies:


Do you know what gluten is and why one would need to avoid it?

______Yes ______No

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EMPLOYMENT HISTORY

Present or Last Position:

Employer: ___________________________________________________

City: ___________________________ State: _____________________

From: ___________________________ To: _______________________

Responsibilities:


Reason for Leaving: ___________________________________________


Previous Position:

Employer: ___________________________________________________

City: ___________________________ State: _____________________

From: ___________________________ To: _______________________

Responsibilities:


Reason for Leaving: ___________________________________________



I certify that information contained in this application is true and complete. I understand that
false information may be grounds for not hiring me or for immediate termination of
employment at any point in the future if I am hired. I authorize the verification of any or all
information listed above.

Signature___________________________________________Date_________________



Mail or Return application to:

Madwoman Foods Bakeshop & Foodery
4747 Nicollet Ave S
Minneapolis, MN 55419
(612) 825-6680

Note: This is an MS Word document. You may download off our website (
www.madwomanfoods.com ) , complete in MS Word, and attach to an email addressed to
info@madwomanfoods.com


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