Employment Application
Date of Application
An Equal Opportunity Employer
Month Day
Year
? It is the company's policy to provide equal opportunity in conformance with all applicable laws
PERSONAL
NAME:
LAST
FIRST
MIDDLE
SOCIAL SECURITY NUMBER
HOME PHONE
ADDRESS:
CITY
STATE
ZIP CODE
DAYTIME PHONE
ARE YOU UNDER THE AGE OF 18?
YES___
NO___
CAN YOU SUBMIT PROOF OF AGE?
YES___
NO___
NAME/ADDRESS/PHONE OF PERSON TO CONTACT IN CASE OF EMERGENCY?
EMPLOYMENT DESIRED
WHAT TYPE OF WORK ARE YOU INTERESTED IN?
WAGE DESIRED?
ARE YOU CURRENTLY EMPLOYED?
YES___
NO___
IF YES, MAY WE CONTACT YOUR PRESENT EMPLOYER
YES___
NO___
ARE THERE ANY HOURS, SHIFTS OR DAYS THAT YOU CANNOT OR WILL NOT WORK?
IF YES, WHEN?
YES___
NO___
DATE AVAILABLE FOR EMPLOYMENT:
DO YOU HAVE ADEQUATE TRANSPORTATION TO GET TO WORK?
YES___
NO___
GENERAL INFORMATION
HAVE YOU EVER WORKED FOR THIS COMPANY PREVIOUSLY?
YES___
NO___
IF YES, WHEN?
WHERE?
FRANCHISE OWNER'S NAME
REASON/S FOR LEAVING:
ARE YOU ABLE TO PERFORM ALL THE ESSENTIAL FUNCTIONS OF THE JOB WITH OR WITHOUT REASONABLE ACCOMMODATIONS FOR WHICH YOU ARE APPLYING?
YES___
NO___
HAVE YOU EVER BEEN CONVICTED OF A FELONY?
IF YES, PLEASE EXPLAIN:
YES___
NO___
WHEN?______________
WHERE?______________
ACTION TAKEN?_______________
IF HIRED, DO YOU AGREE TO ABIDE BY THE SAFETY RULES OF THE COMPANY?
IF HIRED, CAN YOU PROVIDE PROOF OF ELIGIBILITY TO WORK IN THE UNITED STATES?
YES___
NO___
YES___
NO___
HAVE YOU EVER BEEN COUNSELED FOR CASH HANDLING SITUATIONS?
YES___
NO___
IF YES, PLEASE EXPLAIN:
EDUCATIONAL HISTORY
SCHOOL
NAME AND LOCATION
MAJOR
LEVEL OR YEARS COMPLETED
TYPE OF DEGREE OR CERTIFICATE ATTAINED
HIGH SCHOOL
COLLEGE
OTHER
IDENTIFICATION REQUIREMENTS
THE IMMIGRATION AND CONTROL ACT OF 1986 REQUIRES THAT, IF HIRED, BEFORE YOU START WORK, YOU PRESENT TO THE SELECTING MANAGER, DOCUMENTS WHICH
ESTABLISH YOUR IDENTITY AND ELIGIBILITY TO WORK IN THE UNITED STATES. SOME OF THE DOCUMENTS MAY INCLUDE:
UNITED STATES PASSPORT
DRIVER'S LICENSE
STATE ID CARD WITH PHOTO
CERTIFICATE OF CITIZENSHIP
SOCIAL SECURITY