Employment Data

If you are under 18 and we require a work permit, can you furnish one?*

Yes

No

If no, please explain:

Have you ever worked for Flour Shoppe Cafe?*

Yes

No

If yes, when?

Are you a citizen of the United States?*

Yes

No

If not, are you legally allowed to work in the United States?

Yes

No

Have you ever pleaded "guilty", "no contest", or been convicted of a crime?*

Yes

No

If yes, please provide dates and details:

Answering "yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.

Previous Employment History

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Job 1

Dates of Employment:

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Job 2

Dates of Employment:

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Job 3

Dates of Employment:

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By submitting the information below the applicant attests that they are able to legally seek employment in the United States and the following certifications:

• I certify that the information contained in this application is correct to the best of my knowledge.
• I understand that to falsify information is grounds for Flour Shoppe Cafe refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, educational and qualifications for employment.
• I also authorize Flour Shoppe Cafe to request and receive such information.
• In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted any any time, at Flour Shoppe Cafe's sole option and without prior notice to me.
• I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of Flour Shoppe Cafe or myself.

Flour Shoppe Cafe is an equal opportunity employer and promotes non-discriminatory practices and procedures in all phases of its operations and prohibits any form of unlawful discrimination and other considerations made unlawful by federal or state laws including race, does not discriminate in employment and activities on the basis of race, national origin, color, creed, religion, sex, age, disability, veteran status, sexual orientation, gender identity, or associational preference. Non-discrimination does not guarantee an employee or member of the public any rights not otherwise provided by law.

By the applicant entering their name in the box below, they are electronically signing this application and it carries the same legal value as if it were signed by the applicant in person.