The Bread Project
Food Prep & Baking Job Training & Placement Program Application
Email *
Start Date & End Date M-F 9am-3:30pm *
Required
I understand that I am filling out an application for a job training program at The Bread project (TBP). This application is strictly confidential and all information is used for TBP purposes. I understand that filling out this application does not equate to being accepted into the program. *
Required
Please check the boxes below to indicate that you meet each of the following program requirements: *
Required
Do you need...
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Full Legal Name *
Other/Preferred Names (including aliases)
Street Address, City, State, and Zip-code
Home Phone and/or Cell Phone *
Date of Birth *
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Gender *
Pronouns *
Have you ever served in the armed forces (are you a vet)? *
Race/Ethnicity *
Required
Education (check all that apply) *
Required
Have you done another food-service or job training program or worked in commercial food service? *
Do you have a Food Handlers card? *
If yes, when does it expire?
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DD
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Are you currently homeless (with no permanent place to live)? *
How many times have you been homeless in the past three years (including now)?
Where do you live or stay right now? *
Required
If you are in a Shelter or Transitional Housing Facility please provide Name, City.
Do you have a disability that substantially limits major life activities. See ADA definition: The American with Disabilities Act defines "substantially limits" (i) Unable to perform a major life activity that the average person in the general population can perform; or (ii) Significantly restricted as to the condition, manner or duration under which an individual can perform a particular motor activity as compared to the condition, manner, or duration under which the average person in the general population can perform that same major life activity. (For example: Mental illness, physical disabilities, substance abuse, development or learning disability. *
Are you willing to submit to a drug test for employment purposes? *
Do you have any of the following health conditions?
Have you been convicted of a criminal offence?
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If yes, what type of conviction?
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Are you currently on *
If yes do you have
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Are you the person who is mainly responsible for your household finances (are you the head of your household?
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How many people are in your household, including yourself?
Which of these do you currently receive?
If you currently receive any of these services, please specify how much you receive from each source. *
How did you hear about The Bread Project? (Name of person, agency)
Emergency Contact Information (Please provide one or two people we may contact in an emergency) *
I give permission to The Bread Project to share and/or secure and information necessary to process my application for the training program. I also grant The Bread Project permission to contact other individuals or organizations in order to provide services and resources on my behalf. I understand that this information will be shared or secured on a professional basis only, while protecting my right to confidentiality. I am authorizing The Bread Project to contact any person or organization required to process my application and enrollment, obtain services/provide referrals while enrolled in the program and to help obtain employment. I will update The Bread Project of my status regarding, but not limited to, housing and participation in partner programs. I understand that I have the right to deny this permission at any time. If I do this, I understand I am not longer eligible for the program or able to receive program services. I declare the above information on the application, along with information supplied on my resume, if any, is true and correct. I understand that completing this application does not equate being accepted to the program. I understand that, in the event of my acceptance and/or enrollment by The Bread Project, I shall be subject to dismissal if any information that I have given in such materials is false or misleading, or if I failed to give any information herein requested, regardless of the time elapsed after discovery. Please type your full name as an agreement to these terms and conditions. *
A copy of your responses will be emailed to the address you provided.
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