Mariposa Application

Statement of Values

Dear Applicant:

Welcome to Jantz Café & Bakery. Prior to completing the application for employment, please understand that we are serious about creating a productive working environment for our staff and maintaining the highest levels of quality, service, and attention for our guests.

We want you to understand that we also believe in living our values, some of which are:
- We believe that good enough isn’t.
- We believe in doing business in a professional and orderly manner.
- We believe in honesty and integrity.
- We believe that only a happy and professional staff can give the level of personal service we demand.
- We believe in the ongoing training and development of our staff and see it as a worthy investment in the future of the company.
- We believe in providing legendary service – the unique and powerful sort of personal care and attention that our guests tell stories about.
- We believe that everyone is capable of being an A+ player.
If this feels like an environment for you, please complete the application.

Date
Month
Day
Year
Position(s) applied for:
How did you find out about this job?
- Online
- Employee
- Walk-in
- Relative
- Other
Why are you seeking a new job at this time?
Applicant Information
Name
First Middle Last
Address
Street Address City State / Province / Region ZIP / Postal Code
Email
Phone
If hired, do you have reliable transportation to work?
Describe:
Are you at least 18 years old?
If you are under 18, can you furnish a work permit?
Are you legally eligible for employment in the U.S.?
Proof of U.S. Citizenship or Immigration Status is required if hired.
List any special skills or training:

Employment Information
Are you seeking full time, part time, or temporary employment?
What hours and shifts would you prefer to work?
List any times you would not be able to work:
I am interested in:
- Back of House
- Front of House
- Management
- Any Position
Are you willing to work overtime?
Weekends?
Holidays?
Are you currently employed?
If hired, when would you be able to start?
Have you ever worked for this organization before?
If yes, name used:
List any friends or relatives employed by this company:
Have you ever been discharged or asked to resign from any position?
If yes, please describe:

Education
Name of School
Location of School
Highest Grade Level Achieved
Degree / Major

Work History
Please begin with the most recent
Company Name
Company Phone
Company Address
Street Address City State ZIP Code
Date Started
Date Ended
Salary Start
Salary End
Job Title
Supervisor's Name & Title
Describe Duties
Reason For Leaving
Do You Have Additional Work Experience To List?
- Yes
- No
Company 2 Name
Company 2 Phone
Company 2 Address
Street Address City State ZIP Code
Date Started
Date Ended
Salary Start
Salary End
Job Title
Supervisor's Name & Title
Describe Duties
Reason For Leaving

Authorizations & At-Will Employment Agreement

(please read carefully, then sign and date below)

I certify that I have personally completed this application. I declare that the information provided in this employment application is true and complete and I understand that any false information or significant omissions may disqualify me from further consideration for employment and may be justification form my dismissal from employment if discovered at a later date. I agree to immediately notify this company if I should be convicted of a crime while my job application is pending or during my employment, if hired.

I authorize this company to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or dis-charge

I specifically authorize and direct my current and former employers to supply employment-related information to this company and do hereby release my current and former employers from liability for providing information to this company.

Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer.

I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investiga-tive report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations.

I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician.

AT-WILL EMPLOYMENT AGREEMENT
I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create an employment contract between the company and me. In addition, I understand and agree that if you employ me, in consideration of my employment, my employment and compensation will be at-will, for no definite period of time, and may be terminated at any time, for any reason, or for no reason at all. I understand that only the company’s President is authorized to change the employment-at-will status and such a change can only be done in writing. I have read, understand, and agree to the above.
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Statement of Values

Applicant Information

Employment Information

Education

Work History

Authorizations & At-Will Employment Agreement