PERSONAL INFORMATION
Name :*
SS# :
Phone :*
Address :*
Email :*


APPLICATION DETAILS
Applying for : FULL TIME PART TIME
Are you employed now? YES NO
May we call them? YES NO
Referred by:
Days & hours available to work?
Weekends? YES NO
Overtime? YES NO
What date could you begin working?
Are you at least 21 years of age? YES NO
Can you show evidence of you U.S.
Citizenship or proof of your legal
right to work in this country?
YES NO


GENERAL INFORMATION
Have you ever been convicted of a
criminal offense (Felony or misdemeanor)?
YES NO
If yes, please state the nature of the crime(s),
when and where convicted and
disposition of the case(s)
NOTE: NO APPLICANT WILL BE DENIED EMPLOYMENT SOLELY ON THE GROUND OF CONVICTIONS OF A CRIMINAL OFFENSE.  THE NATURE, DATE, SURROUNDING CIRCUMSTANCES AND THE RELEVANCE OF THE OFFENSE TO  THE POSITION(S) APPLIED FOR MAY, HOWEVER, BE CONSIDERED.

EDUCATION AND EXPERIENCE (HIGH SCHOOL)
Name:
Address:
# of years completed:
Did you graduate: YES NO
Year Of Graduation:
Degree, Diploma:


PRESENT OR MOST RECENT EMPLOYMENT
LIST BELOW PRESENT OR MOST RECENT EMPLOYMENT
Name Of Employer:
Position and work:
Address:
Phone:
Employment start:
Employment end:
Starting pay:
Ending pay:
Reason for leaving:


I certify that all the information submitted by me on this application is true and complete, I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.
In consideration of my employment, I agree to conform to Juicy Burger’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either myself, or company’s option.