Job Application

Your Personal Information:

Full Name:
*
Used another name?
If yes, list name(s):
Present Address:
Permanent Address:
Personal Phone:
Other Phone:
E-mail:
*
Position Desired:
Salary Expected:

I Can Work: (check all that apply)
Select All Days and Times Available:

Employment Record

Record your most recent position first. Failure to accurately account for all periods during the last seven years may lead to your application not being considered. If omissions or falsifications are discovered subsequent to your employment, such omissions or falsification will be sufficient cause for discharge (List periods of school as follows: School name under company name & dates attended.)

Previously worked here?
If yes, when did you work here?
Previously applied?

Employer #1 (most recent)

Company Name:
Company Address:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending Wage:
Were you unemployed between positions? 
How long and why?

Employer #2

Company Name:
Company Address:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending Wage:
Were you unemployed between positions? 
How long and why?

Employer #3

Company Name:
Company Address:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending Wage:
Were you unemployed between positions? 
How long and why?

Have you ever been asked to resign or been fired for cause? 
May we contact your previous employers? 
Please list any previous employers you wish us not to contact:

Educational Record

Years Completed:
High School Name:
Degree Received:
Course Work:
Trade School Name:
Degree Received:
Course Work:
College Name:
Degree Received:
Course Work:
 

Other Information

Outside Activities or Hobbies:
If you have any friends or relatives currently working at Fitzwilly's please list their names and their relationship to you:
Are you older than 18?
Are you older than 21?
Do you have reliable transportation to get to and from work?
Have you ever been denied a bond?  

Military Service

Are you now, or have you ever been in the military?
If yes, list branch of service and highest rank attained:
If in reserves, are you currently active?

Immigration Status

If an alien, do you have a legal right to be in the U.S.?
If an alien,
do you have a legal right to accept employment in the U.S.?  
(Upon employment, verification of legal employment status will be required.)

References

Name:
Title:
Phone:
Years Known:
Name:
Title:
Phone:
Years Known:
Name:
Title:
Phone:
Years Known:

Important! Please Read Carefully

I hereby authorize investigation of all statements contained in this application, including inquiry of any and all of my former employers or references as indicated elsewhere on this application, and hold said former employers and/or references harmless from liability arising therefrom. I affirm that all the information contained in this application is true and correct, and that any misrepresentation, falsification or omission herein shall be sufficient reason for dismissal from, or refusal for employment. If employed, I understand that the company reserves the right to modify or terminate my employment at any time, with or without cause, and without prior notice. I further understand that the duration, hours, nature, compensation and benefits of my employment may be changed or modified from time to time without limitation or condition. I understand that no representative of the company has any authority to make any assertions to the contrary. I hereby agree to abide by all policies and rules of this company which govern dress, hair, grooming and attitude.

 
Data processing is in progress