Working at Weiland s please read this first: Working at Weiland s means that you agree to make a serious commitment to providing great customer service, learning about great food, and bringing positive energy to work every day. We know not everyone will care as much about these things as we do. If Weiland s isn t for you, we wish you the best in your job search. If you think this is the place for you, we d love for you to fill out this application. Two important notes: Please make sure your application is complete, including your references; we won t schedule an interview with you if your application isn t complete. Also, we are a Drug-Free Workplace, and you will be tested for drugs shortly after you re hired (our test is cheat-proof). Today s date Name Street address City State ZIP Telephone Email: Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You will be required to provide documentation.) Yes No Do you want to work: Full-time Part-time Please mark the times you are available to work: AM PM Mon Tues Wed Thurs Fri Sat Sun Are you at least 18 years old? (If you re under age 18, you can still apply as a bagger.) Yes No Have you ever been convicted of a criminal offense? Yes No If yes, please describe the offense: Are you applying for a specific job opening? How were you referred to us? Have you ever applied at Weiland s? Yes No If yes, when? Have you ever been employed by Weiland s? Yes No If yes, when? What date can you start? What are your pay requirements? Updated 04/18/13 1
Education School Name and Location Degree/Major Completed? High School Yes No College Yes No College Yes No Post-College Yes No Other Training Are you planning to continue your education? Yes No Yes No If yes, where and what courses of study? Please list any other training, experience, skills, or other qualifications, including hobbies, which we should consider while evaluating your application: Do you smoke? Yes No If you answered no, when was the last date you smoked? Have you ever been disciplined for violating workplace policies forbidding the use of alcohol or tobacco products? Yes No If yes, please describe: Do you use illegal drugs? Yes No How many days of work did you miss last year? Employment History Please list your current or most recent employer first. Please use the back of this page or another sheet of paper if necessary. See resume is not an option; we need the information here, too. Address Telephone Updated 04/18/13 2
Duties Why did you decide to leave (if you re still working at this job, why are you looking for a new job)? Address Telephone Duties Why did you decide to leave? Address Telephone Duties Why did you decide to leave? Address Telephone Duties Why did you decide to leave? Updated 04/18/13 3
Please answer the following true/false questions: I enjoy seeing the sunrise. True False I can work weekends. True False I enjoy working in the evenings. True False I enjoy working in the mornings. True False I get along well with co-workers. True False I don t mind working around the holidays. True False I can work many hours in December. True False I love to eat great bread. True False I bring positive energy to work every day. True False I enjoy providing great customer service. True False I can lift at least 25 pounds. True False I can be on my feet for an 8-hour shift. True False I pay attention to details. True False I have good people skills. True False Please answer the following questions: Weiland s is a high-volume business, with high expectations for customer service, and a work day that can be long and stress-filled. What makes you believe you can perform well and excel here? Weiland s is a very service-oriented business. What does good service mean to you? Updated 04/18/13 4
Describe a real incident in which you were treated rudely as a customer. How would you have handled it differently if you had been in the other person s shoes? If you have ever shopped at Weiland s, please describe what you enjoyed most about experience. What experience and knowledge do you expect to gain from working at Weiland s? When we talk with your references, what do you think they will name as your greatest strength and your greatest weakness? Updated 04/18/13 5
References List three references (not related to you) who have known you for more than one year. Name Phone Years Known Address Name Phone Years Known Address Name Phone Years Known Address Please Read Before Signing: I certify that all information provided by me on this application is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application. I authorize my previous employers, schools, or persons listed as references to give any information regarding employment or educational record. I agree that this company and my previous employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this application. In the event of any employment with this company, I will comply with all rules and regulations as set by the company in any communication distributed to the employees. In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide approved documentation to the company that verifies my right to work in the United States on the first day of employment. I have received from the company a list of the approved documents that are required. I understand that employment at this company is at will, which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements. Signature Date Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status. Updated 04/18/13 6