Vermont Teddy Bear Company®

6655 Shelburne Rd., P.O. Box 965 Shelburne , VT. 05482Phone (802)985-3001 Fax (802)985-1330

VermontTeddyBear.comJob Hotline: (802)985-1397 Ext. 1718

Application for EmploymentPLEASE PRINT, except for signature line.

Name ___________________________________________________________________________________________

Address _________________________________________________________________________________________

Primary Phone _______________________________________Secondary Phone _______________________________The Vermont Teddy Bear Company is required by law to verify your employment eligibility. Proof of citizenship or immigration status will be required upon employment.

Email _____________________________________________________

Position(s) applied for: ______________________________________________________________________________

How did you find out about this position? _______________________________________________________________

What type of employment are you seeking? c Full Time c Part Time c Temporary

When could you begin employment? ___________________________________________________________________

What schedule are you available to work? (Time - include a.m. or p.m.)

NOTE: You are not required to indicate your schedule unavailability if due to religious practices before a job offer is made. If you have such an issue, after a job offer is made, please notify the manager and efforts will be made to accommodate your religious practices.

Are you 18 or over? c Yes c No If “no”, please state your age ___________

Are you currently a student or planning to go to school within the next 6 months? c Yes c No

If “yes”, does this impact your ability to work, and if so, how? ________________________________________________

Have you ever filed an application with us in the past? c Yes c No If yes, when? ______________________________

Have you ever worked for The Vermont Teddy Bear Company in the past? c Yes c No If yes, in what capacity?________________________________________________________________________________________________

List any friends or relatives currently working for us: _______________________________________________________

Have you ever been convicted of, or placed on probation for, any felonies or misdemeanors in the last ten years? Note: A conviction

will not automatically disqualify a candidate from consideration for employment.

c Yes c No If yes, please explain: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

An Equal Opportunity EmployerWe are an equal opportunity employer and do not discriminate against any applicant because of race, color, religion, sex, national origin, age,

disability, sexual orientation, marital status, ethnicity, place of birth, veteran status, HIV positive or any other legally protected characteristic, as required by law. It is our intention that all applicants be given equal opportunity and that selection decisions be based on job-related factors.

Street City State Zip

Sunday Monday Tuesday Wednesday Thursday Friday SaturdayMornings Mornings Mornings Mornings Mornings Mornings Mornings

Afternoons Afternoons Afternoons Afternoons Afternoons Afternoons Afternoons Evenings Evenings Evenings Evenings Evenings Evenings Evenings All All All All All All All

EducationCircle highest grade completed: High School 9 10 11 12 College 13 14 15 16 17

High School: Name ___________________________________________location _______________________________

Diploma or GED: c Yes c No

College or vocational school: List course of study, number of years attended and graduation date. ____________________

________________________________________________________________________________________________

Other courses or training: ___________________________________________________________________________

Employment RecordPlease complete in full even though you may have a resume. List employers in consecutive order beginning with current or last

employer. Account for all periods of time including any periods of unemployment. If self employed, provide company name and supply

business references.

Company __________________________________________________Address _______________________________

Telephone No.______________________________Supervisor’s name and title _________________________________

Position Held______________________Employed from_________to__________Rate of pay _____________________

Duties ___________________________________________________________________________________________

Reason for leaving _________________________________________________________________________________

May we contact this employer? c Yes c No If no, why not? ___________________________________________

Company __________________________________________________Address _______________________________

Telephone No.______________________________Supervisor’s name and title _________________________________

Position Held______________________Employed from_________to__________Rate of pay _____________________

Duties ___________________________________________________________________________________________

Reason for leaving _________________________________________________________________________________

May we contact this employer? c Yes c No If no, why not? ___________________________________________

Company __________________________________________________Address _______________________________

Telephone No.______________________________Supervisor’s name and title _________________________________

Position Held______________________Employed from_________to__________Rate of pay _____________________

Duties ___________________________________________________________________________________________

Reason for leaving _________________________________________________________________________________

May we contact this employer? c Yes c No If no, why not? ___________________________________________

Company __________________________________________________Address _______________________________

Telephone No.______________________________Supervisor’s name and title _________________________________

Position Held______________________Employed from_________to__________Rate of pay _____________________

Duties ___________________________________________________________________________________________

Reason for leaving _________________________________________________________________________________

May we contact this employer? c Yes c No If no, why not? ___________________________________________

ReferencesPlease provide at least 3 professional references.

Name____________________________________Address____________________________________________________

Telephone No. ________________________________________Years acquainted________________________________

Please check: c Professional c Personal How do you know this individual?_________________________________

Name____________________________________Address____________________________________________________

Telephone No. ________________________________________Years acquainted________________________________

Please check: c Professional c Personal How do you know this individual?_________________________________

Name____________________________________Address____________________________________________________

Telephone No. ________________________________________Years acquainted________________________________

Please check: c Professional c Personal How do you know this individual?_________________________________

Name____________________________________Address____________________________________________________

Telephone No. ________________________________________Years acquainted________________________________

Please check: c Professional c Personal How do you know this individual?_________________________________

Employment DataPlease provide any additional information relative to change of name, use of assumed name or nickname, that is necessary to enable

us to check your employment or personal references: ______________________________________________________

________________________________________________________________________________________________

Please list any special skills, qualifications or experience relevant to the position(s) for which you are applying: ___________

________________________________________________________________________________________________

________________________________________________________________________________________________

Applicant’s certification, authorization and releaseI understand that the receipt of this application does not imply that I will be employed by The Vermont Teddy Bear Company. All employment at the

Vermont Teddy Bear Company is at-will.

I authorize all persons, schools, employers and organizations mentioned in this application to provide The Vermont Teddy Bear Company and/or its

representatives with any and all information requested by The Vermont Teddy Bear Company. The Company representative may ask any questions

pertinent to the hiring decision, including questions about my personal background, education, work experience, character and personality. I volun-

tarily release such persons, schools, employers and organizations from any and all liability for providing such information. Further, I voluntarily release

The Vermont Teddy Bear Company and its representatives from any and all liability that may result from the collection of such information.

Should The Vermont Teddy Bear Company make an offer of employment, an investigative consumer report may be requested which may include

information about my employment (including my current or most recent position), education, credit history and criminal history, if any. I affirm

that I have supplied complete and correct information to the questions on this application and that I have withheld nothing. I understand that any

omissions, falsification or derogatory information may adversely affect either my eligibility for employment or continued employment with VTBC if

already employed when the information is received.

Signature of Applicant ______________________________ Date ___________________________

Mission StatementTo make the world a better place, one bear at a time.

Brand Soul Elements Keep Promises Stay Rooted in Vermont Have Fun Create the Best Bears Be Different Get Personal

Vermont Teddy Bear Company6655 Shelburne Rd., P.O. Box 965 Shelburne , VT. 05482

Phone (802)985-3001 Fax (802)985-1330VermontTeddyBear.com

Job Hotline: (802)985-1397 Ext. 1718REV20060103