Lumpy’s Bakery P.O. Box 426, Harrison City, PA 15636-0426 724-744-0325 (office) 724-744-7677 (store) 724-744-0358 (fax) lumpysbakery@gmail.com Employment Application Birth Last Name First M.I. Date Street Apartment/Unit # Address City State ZIP Phone Cell Phone Social Security Date Available Desired Salary No. Position Applied for E-mail Address Previous Apartment/Unit # Street Address City State ZIP Previous Apartment/Unit # Street Address City State ZIP If no, are you Are you a citizen of the United States? YES NO authorized to work YES NO in the U.S.? Have you ever worked for this company? YES NO If so, when? If yes, Have you ever been convicted of a felony? YES NO explain We execute random drug testing upon employment. Have you ever been drug YES NO If so, when? tested before? Please list three professional references. Full Name Relationship Company Phone ( ) Address Full Name Relationship Company Phone ( ) Address Full Name Relationship Company Phone ( ) Address
Lumpy’s Bakery P.O. Box 426, Harrison City, PA 15636-0426 724-744-0325 (office) 724-744-7677 (store) 724-744-0358 (fax) lumpysbakery@gmail.com Employment Application Last Name First M.I. Birth Date Street Address Apartment/Unit # City State ZIP Phone Cell Phone Date Available Social Security No. Desired Salary Position Applied for E-mail Address Previous Street Address Apartment/Unit # City State ZIP Previous Street Address Apartment/Unit # City State ZIP Are you a citizen of the United States? YES NO If no, are you authorized to work in the U.S.? YES NO Have you ever worked for this company? YES NO If so, when? Have you ever been convicted of a felony? YES NO If yes, explain We execute random drug testing upon employment. Have you ever been drug tested before? YES NO If so, when? Please list three professional references. Full Name Relationship Company Phone ( ) Address Full Name Relationship Company Phone ( ) Address Full Name Relationship Company Phone ( ) Address