Date of Application
Street Address
City
State
Zip
Phone Number
Email
Are you 18 years of age or older?
Yes
No
Y/N
Are you eligible to work in the United States?
Yes
No
Y/N
Do you have a current and valid Food Handler’s Card?
Yes
No
Y/N
Do you have reliable transportation to and from work?
Yes
No
Y/N
Do you have a valid driver’s license? (For managers only)
Yes
No
Y/N
Are you a military dependant?
Yes
No
Y/N
Have you ever worked in any Deli or Bakery business?
Yes
No
Y/N
If yes, Where?
Have you ever worked in a military commissary before?
Yes
No
Y/N
If yes, Where?
Have you worked for MDBS before?
Yes
No
Y/N
If yes, Where?
Are you related to anyone who is employed by MDBS?
Yes
No
Y/N
If Yes, provide MDBS employee’s name and relationship to you
Are you friends with anyone who is employed by MDBS?
Yes
No
Y/N
If Yes, provide MDBS employee’s name and relationship to you
Position or Positions desired
Wage Rate expected:
Number of hours per week that you are available
Date available to start work
Please indicate days and times available to work
Mondays
Available from
to
or
Available from
Available from
Available from
Available from
Available from
Available from
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
to
to
to
to
to
to
or
or
or
or
or
or
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
Not Available
If currently employed, describe why you want to change jobs
During the past 5 years, have you ever been convicted of, pled guilty to or
pled no contest to, a crime, excluding misdemeanors and traffic violations?
Yes
No
Y/N
Deli/Bakery workers often stand on their feet for an entire shift.
Are you able to stand on your feet for up to 8 hours per day?
Yes
No
Y/N
Deli/Bakery employees handle fresh, ready-
to-
eat foods. Are you
under the care of a physician for any communicable disease?
Yes
No
Y/N
If yes, please list any special accommodations
Deli/Bakery employees may be required to lift up to 75 boxes weighing
20 to 25 pounds each during their shift. Are you able to lift these amounts?
Yes
No
Y/N
If no, please list any special accommodations
Do you have any conditions or special requirements that might
affect your ability to perform physical type work for extended periods?
Yes
No
Y/N
If yes, please list any special accommodations
FOR CAKE DECORATORS ONLY
:
Do you have any conditions or physical limitations which could affect
your ability to decorate cakes or squeeze icing bags repeatedly for
extended periods of time?
Yes
No
Y/N
If yes, please list any special accommodations
FOR CAKE DECORATORS ONLY
:
Do you squeeze icing bags with one hand or two hands?
One Hand
Two Hands
Hands?
Employment History
Highest level of education
High School
Some College
College Graduate
Please Choose
Company Name
Phone Number
Job Title
Start Date
End Date
Company Name
Phone Number
Job Title
Start Date
End Date
Company Name
Phone Number
Job Title
Start Date
End Date
Company Name
Phone Number
Job Title
Start Date
End Date
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