Online Application Applicant Name: * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number Email * Date of Application Position(s) applying for: Soda Enthusiast Baker (Overnight) Both How did you hear about this position? What days are you available to work? What hours or shift are you available for work? If needed, are you available to work overtime? On what date can you start working, if hired? Do you have reliable transportation to and from work? Salary Desired? Personal Information Are you a U.S. citizen or approved to work in the United States? Yes No What document can you provide as proof of citizenship or legal status? Do you have any condition which would require job accommodations? Yes No If yes, please describe accommodations required. Have you ever been convicted of a criminal offense (felony or misdemeanor)? Yes No If yes, please state the nature of the crime(s), when and where convicted and disposition of case. (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.) Job Skills/Qualifications Please list below the skills you possess for the position for which you are applying: (Note: Stop n Pop LLC complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.) Education and Training Highschool Name: Location (City, State) Year Graduated Degree Earned College/University Name Location (City, State) Year Graduated Degree Earned Vocational School/Specialized Training Name Location (City, State) Year Graduated Degree Earned Previous Employment Employer Name: Job Title Previous Salary Supervisor Name Employer Address Employer Telephone Dates Employed Reason for Leaving Employer Name: Job Title Previous Salary Supervisor Name Employer Address Employer Telephone Dates Employed Reason for Leaving Employer Name: Job Title Previous Salary Supervisor Name Employer Address Employer Telephone Dates Employed Reason for Leaving References Please provide three personal and professional references below: Reference No. 1 Contact Information Reference No. 2 Contact Information Reference No. 3 Contact Information AT-WILL EMPLOYMENT The relationship between you and the Stop n Pop LLC is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Stop n Pop LLC. No representative of Stop n Pop LLC has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President. Stop N Pop LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative. Applicant Signature: Virtual Signature, Type Below: Dated: Thank you!