application for employment

Food For Thought is an equal opportunity employer; we provide equal opportunity to all employees and applicants without regard to race,
color, national origin, ancestry, religion, gender, age, disability, genetics, sexual orientation, gender identity, veteran status, marital status
or any other legally protected category.

Last Name First Name Middle Initial Today’s Date

Address City State Zip Code

Home Phone Cell Phone E-mail Address

JOB INTEREST
Position(s) of Interest: (1) (2)

Desired Rate of Pay: Date Available for Work:

Are you available to work: Full-Time Part-Time On-Call Temporary/Seasonal Internship

Specify any days or hours you are unable to work:

Have you previously been employed by Food For Thought? Yes No If yes, give dates and position:

Are you legally authorized to work in the United States? Yes No (Proof of employment eligibility is required upon employment.)

EDUCATION
Name & Address of School Course of Study Number of Did You Degree or
Years Attended Graduate? Diploma
High School

College or
Secondary
Certifications
or Other

BUSINESS REFERENCES
Name Address Daytime Phone Years Known Relationship

Have you worked for Food For Thought through an employee rental agency or “staffing agency” in the past six months? Yes No
If yes, please specify the agency and date(s):

The following 2 questions are for positions requiring driving only:

Are you legally authorized to drive in the State of Illinois? Yes No
As a condition of employment, I understand that I must keep my employer informed of any change to my driving
Initials status/record within 5 days of its occurrence, i.e., ticket, at-fault accident, DUI, suspension/loss of driver’s license or other
relevant occurrence. I understand that failure to do so may result in employment termination.
EMPLOYMENT HISTORY
Begin with your most recent employer. Please account for all time including part-time/temporary positions. You may submit a resume in
addition to this application; however, this section must still be completed.
Business Name: Permission to contact? Yes No Dates Employed: Hourly Wage or Salary:

Start: End: Start: End:

Address: Supervisor’s Name, Title and Telephone Number:

Job Title: Description of Duties:

Reason for Leaving:

Business Name: Permission to contact? Yes No Dates Employed: Hourly Wage or Salary:

Start: End: Start: End:

Address: Supervisor’s Name, Title and Telephone Number:

Job Title: Description of Duties:

Reason for Leaving:

Business Name: Permission to contact? Yes No Dates Employed: Hourly Wage or Salary:

Start: End: Start: End:

Address: Supervisor’s Name, Title and Telephone Number:

Job Title: Description of Duties:

Reason for Leaving:

Have you ever been fired, dismissed, asked to resign or otherwise terminated from any job? Yes No (a yes answer does not
necessarily prohibit employment). If yes, please explain:

PLEASE REVIEW EACH OF THE STATEMENTS BELOW

I certify that all statements (verbal and written) made on any and all material collected during the hiring process are true,
complete and accurate and I understand that misrepresentation or omission of facts called for in the employment application,
resume, interview process or other application material may prohibit consideration for employment at Food For Thought and
is cause for immediate termination if employed.
I authorize Food For Thought to conduct a criminal background check, as well as personal and professional background
checks, for the purposes of consideration of this application. Food For Thought may contact any references, past and current
employers and any other individual or organization that might be relevant to the position for which I am applying with the
exception of those specifically excluded on this application. I hereby release all of these references, employers and other
individuals/organizations from any and all liability for damages that might occur in connection with the processing of this
application.
I understand and agree that my employment relationship with this organization is an at-will relationship, meaning that both
the organization and I have the right to terminate this employment relationship at any time for no reason or for any reason, as
long as that reason is not illegal. No verbal promises or guarantees can change this at-will relationship. Any changes to the
at-will relationship or its terms must be in writing, for the agreed purpose of changing the relationship, and signed by me and
by an authorized officer of this organization.
Food For Thought is an equal opportunity employer and prohibits/does not tolerate discrimination in any form, including
harassment, on the basis of race, color, national origin, ancestry, religion, gender, age, disability, genetics, sexual orientation,
gender identity, veteran status, marital status or any other legally protected category.
My signature indicates that I have read and fully understand all of the above statements.

Applicant’s Signature: Date: