LaChoclatier Bakery LLC

Employment Application

Email completed application to manager@lachoclatier.com

Applicant Information
Date	Position Applying For
First Name	Middle Initial		Last Name
Address	City			State	Zip
Phone	Date Available
Email				Desired Salary
Are you a citizen of the United States?	YES ___ NO ___
Have you previously applied to LaChoclatier?	YES ___ NO ___
Have you ever worked for another bakery?	YES ___ NO ___	If so, which bakery?
Have you ever been convicted of a felony?	YES ___ NO ___	If yes, explain

Previous Employment
Company			Location
Job Title			Salary
Duties
Start Date	End Date		Reason for Leaving
Company			Location
Job Title			Salary
Duties
Start Date	End Date		Reason for Leaving
Company			Location
Job Title			Salary
Duties
Start Date	End Date	Reason for Leaving

Education
High School		Location
From	To	Did you graduate?	YES ___ NO ___
College		Location		Degree
From	To	Did you graduate?	YES ___ NO ___

Professional References
Name	Relationship
Company	Phone
Name	Relationship
Company	Phone

Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature	Date