*Completed applications may be returned to

the store*

Employment Application
Great Harvest Bread Co.
Robert and Kathy Cappiello, owners
4154 Ogletown-Stanton Road
Newark, DE 19713
302-731-LOAF
www.GreatHarvestNewark.Com
Great Harvest Bread Co. is an Equal Opportunity Employer. We do not
discriminate on the basis of race, religion, color. sex, age, national
origin or disability.

Great Harvest Bread Company is a Drug-Free Zone

Name ___________________________________________________
Telephone # day_________________ evening _________________ cell
________________
Current Address _____________________________________________________________
____________________________________________________________________________

Social Security #_________________________

Date available to start work? __________________________
How did you hear about us? _____________________________________________
What position are you seeking? ______________________________________________
What are your preferred working hours? _____________________________________
Are you at least 18 years of age? _____________
Are you a U.S. Citizen or do you have a permit which allows you to work? Yes

No

In all jobs at Great Harvest, you may have to stand for long periods of time waiting on
customers or kneading bread, lift heavy packages (a bushel of wheat) endure a hot working

environment (have you seen the big oven?) and smile for long periods of time. Can you
do these things, with or without accommodations?
_______________________________________________________________
Explain any accommodations that may be necessary
_________________________________________________________________________
_______________________________________________________________________
In the last 5 years have you been convicted of a criminal offense?
If yes, please explain. ______________________________________________________
What is your highest level of education? ___________________________________
Where did you graduate from (or are still attending) high school?
_________________________________________________________________
Tell us about your college work?
_________________________________________________________________
_________________________________________________________________
Tell us about your favorite college or high school course.
__________________________________________________________________
__________________________________________________________________
Why are you interested in working at Great Harvest?
___________________________________________________________________
___________________________________________________________________
Do you have any special interest, experience or skills (not necessarily job related)?
____________________________________________________________________
Describe you idea of a stressful job situation? _____________________________
__________________________________________________________________
If we were to ask you to describe yourself, what would you say?
__________________________________________________________________
_________________________________________________________________
What are your hobbies?

_________________________________________________________________
What types of music do you enjoy?
_________________________________________________________________
Is there anything else you would like to tell us about yourself that would be pertinent to our
consideration of you for a position at Great Harvest?
________________________________________________________________________
________________________________________________________________________
Employment History
Employer __________________________________________________________
Contact Name ____________________________________________________
Address __________________________________________________________
Phone #

Employed from __________ to________

What were/are your duties

_________________________________________________________________________
_______________________________________________________________________
Reason for leaving
_________________________________________________________________________
_______________________________________________________________________
Would this supervisor or employer hire you back? ____________________________
Explain____________________________________________________________
What did you do at this job that would make you qualified for a job at Great Harvest?
_________________________________________________________________________
_______________________________________________________________________
Employment History
Employer __________________________________________________________
Contact Name ____________________________________________________
Address __________________________________________________________
Phone #

Employed from __________ to________

What were/are your duties

_________________________________________________________________________
_______________________________________________________________________
Reason for leaving
_________________________________________________________________________
_______________________________________________________________________
Would this supervisor or employer hire you back? ____________________________
Explain____________________________________________________________
What did you do at this job that would make you qualified for a job at Great Harvest?
_________________________________________________________________________
_______________________________________________________________________
Employment History
Employer __________________________________________________________
Contact Name ____________________________________________________
Address __________________________________________________________
Phone #

Employed from __________ to________

What were/are your duties

_________________________________________________________________________
_______________________________________________________________________
Reason for leaving
_________________________________________________________________________
_______________________________________________________________________
Would this supervisor or employer hire you back? ____________________________
Explain____________________________________________________________
What did you do at this job that would make you qualified for a job at Great Harvest?
_________________________________________________________________________
_______________________________________________________________________

References

Please give three personal references. These should be former employers, teachers, or
someone else you worked for, not friends or relatives.
Name__________________________________________
Phone # ______________________________________
How do you now this person?
____________________________________________________________________
Name__________________________________________
Phone # ______________________________________
How do you now this person?
____________________________________________________________________
Name__________________________________________
Phone # ______________________________________
How do you now this person?
____________________________________________________________________
I certify that the facts contained in this application are true and correct, and I confirm that
my omission or misrepresentation of any fact on this application is sufficient reason for
Great Harvest to deny me employment. If employed, such and omission or
misrepresentation shall be grounds for dismissal. I further authorize investigation of all
statements contained herein and the references listed above. I agree that if an employment
relationship is established with Great Harvest, it will be of an at will nature. Meaning
that I may resign at any time and Great Harvest may dismiss me at any time with or with
our cause. I understand that in the case of an accident and or injury, the Company reserves
the right to perform drug/alcohol testing.
Signature__________________________________________ Date______________