Application For Employment
We are an Equal Opportunity Employer. All applicants are considered without regard to race, color, religion, gender, national origin,age, disability, veteran status, or any other status protected under local, state or federal laws. Equal access to programs, services
and employment is available to all persons. Those applicants requiring reasonable accommodation for the application and/orinterview process should notify a representative at Eggs’n Things.
Instructions: Please complete each area of information accurately. Any information left unanswered may render this applicationincomplete and therefore unable to be processed.

PERSONAL INFORMATION
Date of Application:

Position Applying For:

Desired Salary:

Date Available to Start:

Phone Number:

Alternate Phone Number:

Name (Last, First, M.I.)
Physical Address (Street, Postal Code, City, Country):
Mailing Address (Street, Postal Code, City, Country):
Email Address:

Please check the type of employment desired:
Please list specific hours of availability for each day: Full-Time  Part-Time  On-Call  Temporary
Please check the days you are available to work:  Sun  Mon  Tues  Wed  Thurs  Fri  SatCan you perform the essential functions of the position you are applying for, with or without reasonable accommodation?
 Yes  No If no, please explain: _______________________________________________________________________________
Do you speak any other languages besides English?  Yes  NoIf yes, which languages? ________________________________________________________________________________________
Do you have a relative or friend currently employed by the Company?  Yes  No
If yes, Name: _______________________ Position: __________________________ Relation: ______________________________
If the position you are applying for requires driving a vehicle, please provide the following:

Driver's License Number:State Issued:

Expiration Date:

EDUCATIONAL BACKGROUND
Name of School

Address (Street, City, State, Zip Code)

No. of Years
CompletedDegree

Major

RelationshipYearsKnown

High SchoolCollegeGraduate
Vocational/TradeREFERENCES (List three individuals who are not relatives)
Name

Occupation

Phone Number

EMPLOYMENT HISTORY (Begin with present or most recent employer)
Company Name:

Position:

Address:

Supervisor's Name:

Start Date:

End Date:

Phone:Starting Salary:Ending Salary:

Supervisor's Name:

Start Date:

End Date:

Phone:Starting Salary:Ending Salary:

Supervisor's Name:

Start Date:

End Date:

Phone:Starting Salary:Ending Salary:Job Duties:
Reason For Leaving:
May we contact this employer?  Yes  No (If no, please explain below:)

Company Name:

Position:

Address:
Job Duties:
Reason For Leaving:
May we contact this employer?  Yes  No (If no, please explain below:)

Company Name:

Position:

Address:
Job Duties:
Reason For Leaving:
May we contact this employer?  Yes  No (If no, please explain below:)

I certify that answers given herein are true and complete to the best of my knowledge. I understand that if I am employed, any
misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or
immediate discharge from Eggs’n Things .
I give Eggs’n Things the right to contact and obtain information from all references, employers, educational institutions and tootherwise verify the accuracy of the information on this application. I hereby release from liability Eggs’n Things and its
representatives for seeking, gathering, and using such information and all other persons, corporations, or organizations forfurnishing such information.
This application is current for only 60 days from the date of application. At the conclusion of this time, if I have not heard from theemployer and still wish to be considered for employment, it will be necessary to complete a new application for employment.
In consideration of my employment, I agree to conform to the company's rules and regulations. I understand that I am free to resign
at any time, with or without cause and without prior notice, and Eggs’n Things reserves the same right to terminate employment at
any time with or without cause and without any prior notice, except as may be required by law. I also understand that the terms
and conditions of my employment may be changed, with our without cause or notice, at any time by the company. This application
does not constitute an agreement or contract for employment for any specified period or definite duration.
I verify that I have read and fully understand the above.

________________________________________
Signature_________________________________________
Print Name_____________________
Date