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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