Various federal, state, and local laws prohibit discrimination based on race, color, sex, religion, national orgin, ancestry, age, disability or marital status. East Balt Bakeries is an equal opportunity employer and your response to any question will not be used as a basis for discrimination, but will be judged on its relevance to the position you are seeking.

* Social Security Number:

If and only if you're under 18 years of age, please state your date of birth:

* May we contact you at work?

Yes   No

* Date Available to Start:

* Are there any days/hours you are unable work?:

* Are you willing to work any shift called upon?:

Yes   No

* Check all that you would consider::

Full-time    Part-time    Temporary    Summer

* Are you willing to relocate?:

Yes   No

* Are you willing to travel?:

Yes   No

* How were you referred to East Balt Bakeries?:

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

	School Name & Location	Degree Received	Number of Years Attended	Did you Graduate?
High School	*			Yes No
College	*			Yes No
Graduate School	*			Yes No
Other	*			Yes No

Branch of Service:

Technical Specialization:

Rank Attained:

* Have you previously worked for East Balt Bakeries., Wendy's International Inc., or any of their subsidiaries?

Yes   No

If yes, please enter the Name, Location, City & State, Supervisor, Position Held, Dates Employed and Reason for Leaving

List employment starting with your most RECENT position. Account for any time during this period that you were unemployed by stating nature of your activities. Please indicate if you were employed under a different name.

Business References: (do not list relatives) (please indicate if you were employed under a different name).

Name	Address	Work Phone	Title	Years Known

* Are you a U.S. citizen or do you have a legal right and necessary documents to work in the U.S.? (Identity and employment eligibility of all new hires will be verified as required be the Immigration Reform and Control Act of 1986.)

Yes   No

* Were you ever discharged by any company?

Yes   No

If yes, give name of company(ies) and reason for discharge:

* Have you ever been convicted of a crime other than a minor traffic violation?

Yes   No

(Note you are not obligated to discuss sealed or expunged records of conviction or arrest nor will such information be asked of you or considered in employment decisions.) The existence of a criminal record will not automatically disqualify you from the job for which you are applying.

If yes, please explain offense and final dispostion:

I understand, with my authorization, an investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record and/or crminal history, subject to applicable federal, state and/or local laws.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of Wendy's International, Inc. and/or East Balt Bakeries.

I understand and agree that, if employed, the employment will be "œat will." That is, either I or East Balt Bakeries. may end the employment relationship at any time for any reason, or for no reason. I understand that receipt of this application by East Balt Bakeries does not imply employment and that this application and/or any other East Balt Bakeries documents are not contracts of employment.

* Applicant's Signature (type name):

* Date: