Application for Employment
Wade’s Dairy, Inc. · 1316 Barnum Avenue, Bridgeport, CT 06610
203-579-9233 · careers@wadesdairy.com
203-579-9233 · careers@wadesdairy.com
Please print clearly and answer every question. Wade’s Dairy, Inc. is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or any other status protected by law.
About you
Last name
First name
M.I.
Today’s date
Street address
Town
State
ZIP
Phone
Other phone
Email
The job
Position applying forDelivery Driver (CDL B)WarehouseOffice / Customer ServiceSalesOther: ________
Looking forFull timePart timeEither
Shifts you can workEarly morningDaysEveningsWeekends
Date you can start: ______________How did you hear about us? ______________________________
Have you worked for Wade’s Dairy before?YesNo If yes, when? ______________
Eligibility
Are you 18 years of age or older?YesNo
Are you legally eligible to work in the United States? (Proof will be required if hired.)YesNo
Can you lift up to 50 lbs and work in a refrigerated cooler, with or without reasonable accommodation?YesNo
Driver’s license (all applicants; required for driving positions)
Do you have a valid driver’s license?YesNo
License number
State
RegularCDL ACDL BCDL CClass
Expires
Endorsements
Has your license been suspended or revoked in the past 3 years? If yes, explain
Education
| High school / GED | Graduated? | YesNo | |
| College / trade school | Degree / certificate |
Application for Employment · page 2
Applicant name: ________________________________
Work history (most recent first; include military service)
| Employer | |||
| Address / phone | |||
| Job title | Dates (from – to) | ||
| Duties | |||
| Reason for leaving | May we contact? | YesNo | |
| Employer | |||
| Address / phone | |||
| Job title | Dates (from – to) | ||
| Duties | |||
| Reason for leaving | May we contact? | YesNo | |
| Employer | |||
| Address / phone | |||
| Job title | Dates (from – to) | ||
| Duties | |||
| Reason for leaving | May we contact? | YesNo | |
References (not relatives)
| Name | Relationship / years known | Phone |
Anything else we should know?
Please read and sign
I certify that the information in this application is true and complete to the best of my knowledge. I understand that false or missing information may be grounds for not hiring me, or for ending my employment if discovered later. I authorize Wade’s Dairy, Inc. to contact my past employers and references listed above. I understand that employment with Wade’s Dairy, Inc. is at will, meaning either I or the company may end it at any time, and that this application is not a contract of employment. If I apply for a driving position, I understand Wade’s Dairy may review my driving record and that DOT-required checks apply.
Signature
Date
Office use only Received ________ Interviewed by ______________ Date ________ Position ______________ Hired? ☐ Yes ☐ No Start ________
Return to Wade’s Dairy, Inc., Attn: Human Resources, 1316 Barnum Avenue, Bridgeport, CT 06610 · or email careers@wadesdairy.com