Employment Application

Position

For which position are you applying?

What position are you applying for?

Which location are you applying for?

Availabilities

Please make sure that the information you enter is accurate.

Day	10am-4pm	4pm-11pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Personal Information

Personal Information (Part 1)

Please make sure that the information you enter is accurate.

First Name

Middle Name

Last Name

Street Address

Apartment/Unit #

City

State

Postal/ZIP Code

Daytime Telephone e.g "(xxx) xxx-xxxx"

Evening Telephone e.g "(xxx) xxx-xxxx"

Telephone where you can receive text messages e.g "(xxx) xxx-xxxx"

Personal Information (Part 2)

Please make sure that the information you enter is accurate.

Date of Birth e.g "MM/DD/YYYY"

Social Security Number

Are you a citizen of the United States?

Are you authorized to work in the United States?

Have you ever been convicted of a felony?

Have you been employed by Jay's Restaurant Group before?

Education

High School

Please make sure that the information you enter is accurate.

Name of High School

Did you graduate?

Address

City

State

College

Please make sure that the information you enter is accurate.

Name of College

Did you graduate?

Address

City

State

Other

Please make sure that the information you enter is accurate.

Name of School

Did you graduate?

Address

City

State

References

Reference #1

Please make sure that the information you enter is accurate.

Name

Relationship

Address

City

State

Telephone

Reference #2

Please make sure that the information you enter is accurate.

Name

Relationship

Address

City

State

Telephone

Reference #3

Please make sure that the information you enter is accurate.

Name

Relationship

Address

City

State

Telephone

Previous Employment

Company #1

Please make sure that the information you enter is accurate.

Company

Job Title

Address

City

State

Reason for Leaving

Supervisor

Telephone

May we contact your previous supervisor for a reference?

Starting Salary

Ending Salary

Started e.g "MM/YYYY"

End Date e.g "MM/YYYY"

I am currently employed by this company

Company #2

Please make sure that the information you enter is accurate.

Company

Job Title

Address

City

State

Reason for Leaving

Supervisor

Telephone

May we contact your previous supervisor for a reference?

Starting Salary

Ending Salary

Started e.g "MM/YYYY"

End Date e.g "MM/YYYY"

I am currently employed by this company

Company #3

Please make sure that the information you enter is accurate.

Company

Job Title

Address

City

State

Reason for Leaving

Supervisor

Telephone

May we contact your previous supervisor for a reference?

Starting Salary

Ending Salary

Started e.g "MM/YYYY"

End Date e.g "MM/YYYY"

I am currently employed by this company

Comments

Do you have any comments that you would like to add?.

Terms of Submission

Please read the disclaimer below carefully before submitting.

By submitting this application for employment, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or miselading information in my application or interview may result in my release.