Panera Bread Employment Application Form

Personal Data:
First Name:
Middle Initial:
Last Name:
Present Address (Street):
City:
State:
Zip Code:
Phone:
Primary Email:
Are you a citizen of the U.S. or do you have a legal right to work in the U.S.? (You will be required to provide proper identification at the time of hire.)
Yes No
Are you sixteen years of age or Older?
Yes No
Position Applying For:	Baker Bakery/café associate Assistant Manager Catering Coordinator
Preferred Bakery Cafe Location:	View Map of our Locations

What type of position are you looking for?	Full-time Part-time Summer Temporary
Total hours per week available:
This is when I am available to work:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
In the past 5 years have you been convicted of a felony? Conviction of felony will not automatically disqualify you from employment.
No Yes
If Yes, When?
Where?
Nature and disposition of conviction:
How did you hear about us?
Were you referred by any current associate at Panera Bread?
No Yes
If Yes, indicate name and location employed:
Have you previously worked at any Panera or Saint Louis Bread Company?
No Yes
If Yes, When?
Where?
Were you interviewed?	No Yes
If Yes, Indicate by whom (If you remember)?
Educational Data:
Name and address of High School attended:
Have you graduated?	No Yes
Name and address of College (Other) attended:
Have you graduated?	No Yes
Major:
Minor or additional subjects of interest:
Name and address of Graduate School attended:
Have you graduated?	No Yes
Major:
Minor or additional subjects of interest:
EMPLOYMENT HISTORY(list all present and past employment beginning with the most recent.)
1: Company name and address:
Immediate Supervisor:
Your Job title or Position:
Phone Number:
Dates of employment:
From (MM/YY):
To (MM/YY):
Reason for leaving(if applicable):
Describe your duties:
If still employed, may we contact your present supervisor?	Yes No
2: Company name and address:
Immediate Supervisor:
Your Job title or Position:
Phone Number:
Dates of employment:
From (MM/YY):
To (MM/YY):
Reason for leaving(if applicable):
Describe your duties:
If still employed, may we contact your present supervisor?	Yes No
3: Company name and address:
Immediate Supervisor:
Your Job title or Position:
Phone Number:
Dates of employment:
From (MM/YY):
To (MM/YY):
Reason for leaving(if applicable):
Describe your duties:
If still employed, may we contact your present supervisor?	Yes No
Please list any other job related accomplishments, professional distinctions, certifications, or verifiable volunteer work that Panera should know about:
Military History :
Military Service Status	Veteran Non-Veteran National Guard Reserves Advanced ROTC
Branch of Service:
Dates of Service:
From (MM/YY):	To (MM/YY):
Did you receive any military training related to the job for which you are applying for?
Yes No
If Yes, Please Explain:
References:
Reference 1:
Name and Occupation:
Address:
Phone:
Reference 2:
Name and Occupation:
Address:
Phone:
DECLARATION (Carefully read each section and initial then sign at bottom.)
I certify that the answers given herein are true and complete to the best of my knowledge, and I authorize investigation of all statements contained in this application, with exception of contacting my present employer if I have so requested. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
While this application will be retained on file for a period of one year (as required by law), I acknowledge that this application will be considered active for a period of sixty (60) days. At that time, I must submit a new application to be considered for any employment openings. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
I understand and acknowledge that unless otherwise defined by applicable law or written agreement with Panera Bread, any employment relationship with the Company is considered “employment at will,” which means the employee may resign at any time and the Employer may discharge the Employee at any time, with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by any conduct unless such change is specifically executed by the President/Vice President of Panera Bread. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
If I should be employed by the Company, I understand that any false, incomplete, or misleading information given on this application or during an interview shall result in immediate discharge. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
I authorize an inquiry into my background by all people, schools, companies, corporations, credit bureaus, law enforcement agencies, doctors and other consumer reporting agencies to supply information concerning my previous employment, education, credit, driving record, etc. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
I authorize the references listed above to give representatives of Panera Bread any and all information concerning my previous or current employment and any pertinent information they may have, personal or otherwise, and release all parties from any and all liability from any damage that may result. I have read, understand and agree to the above statement.
I have read, understand, and agree to the above statement.
Please initial here:
Signature:
Date (MM/DD/YY):

Panera Bread is an Equal Opportunity Employer.

Panera Bread does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a asis prohibited by local, state or federal law.